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HomeMy WebLinkAboutJ A SAFETY SIGN - INSURANCE CERTIFICATEclininir#- 27R35 Taeule ACORD- CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDDIYYYY) osrz8roa PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Flood & Peterson Insurance Inc ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 9351 Grant Street, Suite 600 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Thornton, CO 80229 720 977-7110 INSURERS AFFORDING COVERAGE NAIC # INSURED INSURERA: EMC Insurance Company J & A Safety & Sign, Inc. INSURERS: Pinnacol Assurance dba: Traffic Masters, Inc. 1304 Duff Drive #14 INSURER C: INSURER D: Ft. Collins, CO 80524 INSURER E: LK@u;*T-VC1*1 THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR 0kDDFL INSRE TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE MM/DDDATE POLICY EXPIRATION MM/DD LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS MADE O OCCUR 2D70977 05/30/04 05/30105 EACH OCCURRENCE $1 00D 000 DAMAGE TO RENTEDPREMISES Me occurns cat $1 00ODD MED EXP (Any one person) $5 000 PERSONAL& ADV INJURY $1 000 000 GENERAL AGGREGATE s2,000000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY 7 PELT LOC PRODUCTS - COMP/OP AGG $2 000 000 A AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIREDAUTOS NON-OWNEDAUTOS 2E70977 05/30/04 05/30/05 COMBINED SINGLE LIMIT (Ea accident) $1 ,00�,000 X BODILY INJURY (Per person) $ X BODILY INJURY (Per accident) $ X PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY ANY AUTO AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC AUTO ONLY: AGG $ $ A EXCESSIUMBRELLA LIABILITY X OCCUR CLAIMS MADE RDEDUCTIBLE X RETENTION $ 10000 2J70977 05/30/04 05/30/05 EACH OCCURRENCE $1 00U 000 AGGREGATE $1 D0o 000 $ $ $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIEIOR/PARTNER/EXECUTIVE OFFICERIMEMBER EXCLUDED? If yes, describe under SPECIAL PROVISIONS below 4058170 06/01 /04 06/01 /05 WC SLIMIT O R- E.L. EACH ACCIDENT $100 000 E.L. DISEASE -FA EMPLOYEE _ $100,000 E.L. DISEASE -POLICY LIMIT $500,000 A OTHER Commercial P 2A70977 05/30/04 05/30/05 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS City of Fort Collins Attn: Purchasing Dept. 256 West Mountain Fort Collins, CO 80521 LD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL In DAYS WRITTEN M TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL iE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR AUTHORIZED REPRESENTATIVE rjC- ..... ...4 tavo,rvo) I OT Z FFMz83989 MXB 0 ACORD CORPORATION 1988 ACORD- CERTIFICATE OF LIABILITY INSURANCE 05281 4D"YYY) PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Flood & Peterson Insurance Inc ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 9351 Grant Street, Suite 600 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Thornton, CO 80229 720 977-7110 INSURERS AFFORDING COVERAGE NAIC # INSURED INSURERA: EMC Insurance Company J & Safety &Sign, Inc. INSURER B: Pinnacol Assurance dba: Traffic Masters, Inc. 1304 Duff Drive #14 INSURER C: Ft. Collins, CO 80524 INSURER D: INSURER E: bWVCR VCJ THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. IN3R LTR ADO' INSRd TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE MM/ DIYY POLICY EXPIRATION DATE MWDDIYY LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS MADE FX-1 OCCUR 2D70977 05/30/04 05/30/05 EACH OCCURRENCE $1000000 DAMAGE TO RENTED $100 000 MED EXP (Any one person) $5 000 PERSONAL & ADV INJURY $1 000 000 GENERAL AGGREGATE $2 000 000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO- JECT LOC PRODUCTS - COMP/OP AGG $2 000 OOO A AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIREDAUTOS NON -OWNED AUTOS 2E70977 05/30/04 05/30/05 COMBINED SINGLE LIMIT (Ea accident) $1,000,000 X BODILY INJURY (Per person) $ X BODILY INJURY (Per accident) $ X PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY ANY AUTO AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC AUTO ONLY: AGG $ $ A EXCESS/UMBRELLA LIABILITY X1 OCCUR CLAIMS MADE FDEDUCTIBLE X RETENTION $ 10000 2J70977 05/30/04 05/30/05 EACH OCCURRENCE $1 000 000 AGGREGATE $1 000 000 S B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICERIMEMBER EXCLUDED? If yes, describe under SPECIAL PROVISIONS below 4058170 06/01/04 06/01/05 WC STATU- oTH• E.L. EACH ACCIDENT $100000 _ E.L. DISEASE -EA EMPLOYEE $100,000 E.L. DISEASE - POLICY LIMIT $500,000 A OTHER Commercial P 2A70977 05/30/04 05/30/05 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS City of Ft. Collins is listed as Additional Insured where their Interest may appear. CITY OF FT. COLLINS PURCHASING DEPARTMENT ATTN: JOHN STEPHEN PO BOX 580 FT. COLLINS, CO 80522 LD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 'A0_ DAYS WRITTEN :E TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL iE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR AUTHORIZED —yr—W - --------••--r I Orc emcasTlsa MXB ©ACORDCORPORATION 1988