HomeMy WebLinkAbout254063 W L CONTRACTORS - INSURANCE CERTIFICATE (3)ACORD. CERTIFICATE OF
LIABILITY
INSURANCE
DATE(MMIDDIYYYY)
5/26/2004
PRODUCER (303) 798-2534
-ONLY
Agency,
5721 S . Nevada St.
Littleton CO 80120
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
INSURERS AFFORDING COVERAGE
NAIC #
INSURED
W. L. Contractors, Inc., W. L. Equipment &
6435 W. 55th Ave.
Arvada CO 80002
INSURER A Mountain States Ins.
INSURERB:Safeco Business Ins.
Co.
INSURERC:
INSURER O:
INSURER E:
r-nvFRAr,Fc
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.
INSR
LTR
ADD'L
INBRD
TYPE OF INSURANCE
POLICY NUMBER
POLICY
DATE (MMIDDIM
(
POLICY
( MMIDD EXPIRATION
LIMITS
GENERAL LIABILITY
EACH OCCURRENCE
$ 1,000,000
A
X COMMERCIAL GENERAL LIABILITY
CLAIMS MADE OOCCUR
CPP0098006
5/1/2004
5/l/2005
PREMISES Ea occurrence
$ 100,000
MED EXP (Any one emon
$ 10,000
PERSONAL & ADV INJURY
$ 1,000,000
GENERAL AGGREGATE
$ 2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
PRODUCTS - COMPIOP AGG
$ 2,000,000
17 POLICY I X I JEC I LOC
AUTOMOBILE
LIABILITY
ANY AUTO
COMBINED SINGLE LIMIT
(Ea accident)
$ 1,000,000
X
BODILY INJURY
(Per person)
$
A
ALL OWNED AUTOS
SCHEDULEDAUTOS
BAP0098006
5/1/2004
5/l/2005
X
BODILY INJURY
(Per accident)
$
HIRED AUTOS
NON-OWNEDAUTOS
X
PROPERTY DAMAGE
(Per accident)
$
GARAGE LIABILITY
AUTO ONLY - EA ACCIDENT
$
OTHER THAN EA ACC
$
ANY AUTO
$
AUTO ONLY: AGG
EXCESSIUMBRELLA LIABILITY
EACH OCCURRENCE
$ 8,000,000
X OCCUR CLAIMS MADE
AGGREGATE
$ 8,000,000
E
$
A
DEDUCTIBLE
UMB0098006
5/1/2004
5/1/2005
$
X RETENTION $ 10,000
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY
WC STATU- OTH-
TORY LIMITS ER
ANY PROPRIETOR/PARTNER/EXECUTIVE
E.L. EACH ACCIDENT
$
E.L. DISEASE - EA EMPLOYEE
$
OFFICERIMEMBER EXCLUDED?
If yes, describe under
SPECIAL PROVISIONS below
E.L. DISEASE - POLICY LIMIT
$
B
OTHER Installation Floater
01-CE-714401-04
1/1/2004
1/1/2005
Location 1,000,000
$500. Deductible
Temp & Transit 500,000
DESCRIPTION OF OPERATIONSILOCATIONSIVEHICLES/EXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS
Re: Contractors License
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
City of Ft. Collins
EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL
30 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
P O BOX 580
INSURER ITS AGENTS OR REPRESENTATIVES.
AUTHORIZED REPRESENTATIVE
Ft. Collins CO 80522--
ACORD 25 (2001108) ® ACORD CORPORATION 1988
INS025 (01mps ELECTRONIC LASER FORMS, INC. - (800)327-0545 Page 1 of 2