HomeMy WebLinkAboutSILVERCOOL JBLANCO - INSURANCE CERTIFICATE (2)ACORP CERTIFICATE OF LIABILITY INSURANCE OP ID DATE(MMIDDNYYY)
SILVCOO Ol 28 OS
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATIC
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
Jewell Insurance Associates HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
8480 E. Orchard Road, Ste 5500 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELO'
Greenwood Village CO 80111
Phone:303-740-8101 Fax:303-740-8019 INSURERS AFFORDING COVERAGE NAIC#
INSURERA: Lexington Iaa_ur e
INSURER B: Pinnacol ABBu
Silvercool Service CO. INsuRER c: Owners Insure
JBlanco Enterpris , Inc. dba
8260 Brighton ROa INSURERD:
Commerce City CO0222
COVERAGES
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
NSR
TYPE OF INSURANCE
POLICY NUMBER
DATEYMWDDNY
DATE MMIE POLICY EXPIRATION
LIMITS
GENERAL LIABILITY
EACH OCCURRENCE
$1, 000, 000
A
X COMMERCIAL GENERAL LIABILITY
41LX0332400
01/20/05
01/20/06
PREMISESEaoccurence
$ 3.00,000
MED EXP (Any orie Person)
$ EXCLUDED
CLAIMS MADE [ X] OCCUR
PERSONAL B ADV INJURY
$1,000,000
GENERAL AGGREGATE
$2, 000, 000
GEN'L AGGREGATE LIMIT APPLIES PER:
PRODUCTS-COMP/OP AGG
$1,000,000
1-1 POLICY JET LOC
AUTOMOBILE
LIABILITY
COMBINED SINGLE LIMIT
$1, 000, 000
C
X
ANY AUTO
4487448700
01/20/05
01/20/06
(Ea acclderd)
ALL OWNED AUTOS
BODILY INJURY
SCHEDULED AUTOS
(Per Peron)
S
X
HIRED AUTOS
BODILY INJURY
$
X
NON-OWNEDAUTOS
(Peraceldent)
PROPERTY DAMAGE
$
(Per accident)
GARAGE LIABILITY
AUTO ONLY - EA ACCIDENT
S
ANY AUTO
OTHER THAN EA AOC
$
AUTO ONLY: AGG
$
EXCESSIUMBRELLA LIABILITY
EACH OCCURRENCE
$
OCCUR CLAIMS MADE
AGGREGATE
$
S
DEDUCTIBLE
S
RETENTION $
$
WORKERS COMPENSATION AND
X TORYLIMITS ER
B
LOYERIETOR/ILITY
4076928
10/01/04
10/01 05
/
E.L. EACH ACCIDENT
$500000
ANY
ANY PROPRIETORlPARTNERIEXECUTIVE
O
E.L. DISEASE -EA EMPLOYE
$ 5 0 0 0 0 0
FFFICERIMEMBEREXCLUDED?
describe under
UECIALL
PROVISIONS below
E.L. DISEASE -POLICY LIMIT
$500000
OTHER
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS
City of Fort Collins
Fax: 1-303-221-6707
John Stephen
P. 0. Box 580
Fort Collins CO 80521
FORT002 I SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATIO
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
REPRESENTATIVES.