HomeMy WebLinkAbout103009 PORTER INDUSTRIES INC - INSURANCE CERTIFICATE (28)ACORD CERTIFICATE OF LIABILITY INSURANCE OP ID R
DATE(MM/DWYYYY)
1. PORTE-1
06 it 04
PRODUCER
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
Linden/Bartels & Noe Agency FC
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
1614 Oakridge Drive, Unit A
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Fort Collins CO 80525
Phone: 970429-9304 Fax: 970-229-1398
INSURERS AFFORDING COVERAGE
NAIC #
INSURED
INA: The Hartford_
Porter Industries, Inc.
Attn: he 1 Kendrick
INSURERS: Pinnacol Assurance
INSURER C.
INSURERD:
---
5202"G anie Street
Loveland CO 80537
INSURER E:
rnVFRAGFS
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
POLICY EFFECTIVE
DATE MM/DDIYY
POLICY EXPIRATION
DATE MM/DDIYY
LIMITS
A
GENERAL LIABILITY
X COMMERCIAL GENERAL LIABILITY
CLAIMS MADE 1 E I OCCUR
34UUNTX0464
04/30/04
04/30/05
FACH OCCURRENCE
$1,000,000
PREM�ISEE3Eaoccurence1
$300,000
MED EXP (Any one person)
$ 10 , 000
PERSONAL& ADV INJURY
$1,000,000
GENERAL AGGREGATE
$ 2, 000, 000
GEN'L AGGREGATE LIMIT APPLIES PER:
POLICY X JECT LOC
PRODUCTS-COMP/OP AGG
$2,000,000
Ben.
1 000,000
A
AUTOMOBILE
LIABILITY
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON -OWNED AUTOS
34UUNTX0464
04/30/04
04/30/05
Ea aarcident'BINED INGLELIMIT
$1,000,000
X
BODILY INJURY
(Per person)
$
X
X
BODILY INJURY
(Per aciident)
$
PROPERTY DAMAGE -
(Per accident)
$ --
GARAGE LIABILITY
ANY AUTO
I
AUTO ONLY - EA ACCIDENT
$�
OTHER THAN EA ACC
AUTO ONLY: AGG
$
$
EXCESS/UMBRELLA LIABILITY
OCCUR CLAIMS MADE
DEDUCTIBLE
RETENTION $
EACH OCCURRENCE
$
AGGREGATE
$
$
$
B
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY
ANY PROPRIETOWPARTNER/EXECU�IVE
OFFICER/MEMBEREXCLUDED?
If yes, describe under
SPECIAL PROVISIONS below
4038253
v7j'?/0�? I
07/V1/05
Ulm
X TORY LIMITS ER
—
"
E.L.E.9CHA�CIuENT
$500,000
E.L. DISEASE - EAEMPLOYEE
-
$500,000
E.L. DISEASE -POLICY LIMIT 1
$500,000
OTHER
DESCRIPTION OF OPERATIONS i LOCATIONS I VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS
RE: P509. Certificate holder is named as additional insured, but only as
respects liability arising out of work performed by the named insured.
CERTIFICATE HOLDER CANCELLATION
FTCOLLI SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
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
City of Ft. Collins IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
Attn: Jim O'Neill
256 West Mountain Avenue REPRESENTATIVES.
Fort Collins CO 80521 AU RIZ REPRES CA•��-�V-� � ( G.�
ACORD 25 (2001/08)
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