HomeMy WebLinkAboutWALRITE - INSURANCE CERTIFICATEACORD. CERTIFICATE OF LIABILITY INSURANCE
04/22/2 0
PRODUCER (970) 484-2805
John C. Beckett &Associates, Inc.
220 Smith Street
Ft. Collins CO 80524-
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY 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
Walrite, LLC
6600 North County Road 11C
Loveland CO 80538-
INSURER A: NATIONAL FIRE AND MARINE
INSURERB:
INSURER C:
INSURER D:
NSURER E:
rnVrRAr.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
ADVL
INSRD
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
DATE MMIDD
POLICY EXPIRATION
DATE MMIDDIYY
LIMITS
A
GENERAL LIABILITY
/ /
/ /
EACH OCCURRENCE
$ 1,000,000
X COMMERCIAL GENERAL LIABILITY
PREMISES TORENTED$
100,000
CLAIMS MADE ❑X OCCUR
72LP163308
04/15/2004
04/15/2005
MEDEXP (Any one rson)
$ 5,000
PERSONAL B ADV INJURY
$ 1,000,000
GENERAL AGGREGATE
It 2,000,000
GENT AGGREGATE LIMIT APPLIES PER:
PRODUCTS - COMP/OP AGG
8 2,000,000
X POLICY JJEC LOC
AUTOMOBILE
LIABILITY
ANY AUTO
NO COVERAGE
/ /
/ /
COMBINED SINGLE LIMIT
(Ea accident)
It
BODILY INJURY
(Per Peron)
$
ALL OWNED AUTOS
SCHEDULED AUTOS
/ /
/ /
BODILY INJURY
(Per accident)
$
HIRED AUTOS
NON -OWNED AUTOS
/ /
/ /
PROPERTYDAMAGE
(Per accident)
$
GARAGE LIABILITY
AUTO ONLY - EA ACCIDENT
$
ANY AUTO
NO COVERAGE
/ /
/ /
OTHER THAN EA ACC
It
$
AUTO ONLY: AGO
EXCESSIUMBRELLA LIABILITY
NO COVERAGE
/ /
/ /
EACH OCCURRENCE
$
OCCUR CLAIMS MADE
AGGREGATE
$
9
$
DEDUCTIBLE
/ /
/ /
$
RETENTION $
WORKERS COMPENSATION AND
NO COVERAGE
/ /
/ /
C tt��
TORY LURS OER
EMPLOYERS' LIABILITY
ANY PROPRIETORIPARTNERIEXECUTIVE
E.L. EACH ACCIDENT
$
E.L. DISEASE - EA EMPLOYEE
OFFICER/MEMBER EXCLUDED?
/ /
/ /
If yes, describe under
SPECIAL PROVISIONS below
E.L. DISEASE - POLICY LIMIT
$
OTHER
NO COVERAGE
DESCRIPTION OF OPERATIONS/LOCATIONSIVEHICLESIEXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS
CFI7TIFICATF Nnl IIFR C_ANCELLATInN
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
CITY OF FT. COLLINS
FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE
281 N. COLLEGE
INSURER, ITS AGENTS OR REPRESENTATIVES.
AUTHORIZED REPRESENTATIVE
PO BOX 580
FT. COLLINS CO 80524-
ACORD 25 (2001708) c ACORD CORPORATION 1988
*T i INS025 (0108).05 ELECTRONIC LASER FORMS, INC. - (800)327-0545 Page 1 of 2
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 (2001108)
INS025 (0108).05 Page 2 of 2