HomeMy WebLinkAboutMARKET EQUIPMENT - INSURANCE CERTIFICATEATE (MM/DD/YYYY)
.AEb2BD,� CERTIFICATE OF LIABILITY INSURANCE 12/19/2004
PRODUCER (509)325-3024 FAX (509)325-1803 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Moloney, O'Neill, Corkery & ]ones, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
1206 N Lincoln, Suite #200 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Spokane, WA 99201
INSURERS AFFORDING COVERAGE NAIC #
INSURED Market Equipment Inc INSURERA: Trinity Univrsl Ins Of Kansas
1114 N Ruby INSURERS:
Spokane, WA 99202 INSURER C:
INSURER D:
INSURER E:
nrnreewn_rc
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDINI
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.
INSR
OUDOT
rypE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
DATE IMMIDDIYYi
POLICY EXPIRATION
DATE IMMIDDfM
LIMITS
GENERAL LIABILITY
CPA7102963
12/31/2004
12/31/2005
EACH OCCURRENCE
$ 1,000,00
X COMMERCIAL GENERAL LIABILITY
DAMAGE TO RENTED
$ 100,000
CLAIMS MADE TO CUR
MED EXP (Any one person)
$ 5,000
A
X Blanket Additional
PERSONAL & ADV INJURY
$ 1,000,000
X
Insured 3304960701
GENERAL AGGREGATE
$ 2,000,00
GEN'L AGGREGATE LIMIT APPLIES PER:
PRODUCTS . COMP/OP AGG
$ 2,000,000
POLICY T JECOT LOC
AUTOMOBILE
LIABILITY
ANY AUTO
CPA7102963
12/31/2004
12/31/2005
COMBINED SINGLE LIMIT
(Ea accident)
$
1,000,00
X
BODILY INJURY
(Per person)
$
A
ALL OWNED AUTOS
SCHEDULED AUTOS
HIREDAUTOS
NON -OWNED AUTOS
X
BODILY INJURY
(Peraocident)
$
X
PROPERTY DAMAGE
(Per accident)
$
GARAGE LIABILITY
AUTO ONLY - EA ACCIDENT
$
OTHER THAN EA ACC
$
ANY AUTO
$
AUTO ONLY: AGG
EXCESS/UMBRELLA LIABILITY
EACH OCCURRENCE
$
OCCUR ❑ CLAIMS MADE
AGGREGATE
$
$
$
DEDUCTIBLE
$
RETENTION $
ifKnxwXX)
CPA7102963
12/31/2004
12/31/2005
WC STATU- OTH-
A
EMPLOYERS' LIABILITY'
ANY PROPRIETOR/PARTNER/EXECUTIVE
WASHINGfON STOP GAP
E.L. EACH ACCIDENT
$ 1,000,000
E.L. DISEASE - EA EMPLOYE
$ 11000,000
OFFICERIMEMBER EXCLUDED?
If yes, describe under
SPECIAL PROVISIONS below
E.L. DISEASE - POLICY LIMIT
$ 1,000,000
OTHER
DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS
C.ITY OF FORT COLLINS ARE NAMED AS ADDITIONAL INSUREDS FOR OPERATIONS OF
HE NAMED INSURED AS SHOWN ABOVE.
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL
CITY OF FORT COLLINS
30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,
ATTN • SANDY
BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY
281 N COLLEGE AVE
OF ANY KIND UPON THE INSURER ITS AGENTS OR REPRESENTATIVES.
FORT COLLINS, CO 80522
AUTHORIZED REPRESENTATIVE 1
A
Mike Molone CLH
ACORD 25 (2001/08) FAX: (970)224-6134 OACORD CORPORATION 1988
IMPORTANT
If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement
on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may
require an endorsement. A statement on this certificate does not confer rights to the certificate
holder in lieu of such endorsement(s).
DISCLAIMER
The Certificate of Insurance on the reverse side of this form does not constitute a contract between
the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it
affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon.
ACORD 25 (2001/08)