HomeMy WebLinkAboutWESTERN STATES FIRE - INSURANCE CERTIFICATEACORD,,, CERTIFICATE OF LIABILITY INSURANCE Page 1 of 2 01/05/2004
PRODUCER 877-945-7378 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
Willie North America, Inc. - Regional Cart Center HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
26 Century Blvd. ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
P. O. Box 305191
Nashville, TN 372305191 INSURERS AFFORDING COVERAGE
INSURED Western States Fire Protection Co. INSURERA: Zurich American Insurance Company 16535-000
Cent S.Tucsnnial, oC Way INSURERB:National Union Fire Insurance Company of 19445-005
Centennial, CO 80112 omP
INSURER C:
INSURER D:
'VYCngVCA
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.
ILTRNSR
I TYPEOFINSURANCE
POLICY NUMBER
POLICYEFFECTIVE
DATE (MIWDDrYY1
POLICY EXPIRATION
DATE (MIWDID/M
LIMITS
A
GENERAL LIABILITY
X COMMERCIAL GENERAL LIABILITY
CLAIMS MADE FX-1 OCCUR
GL0348258801
12/31/2003
12/31/2004
EACHOCCURRENCE
$ 2,000,000
FIRE DAMAGE (Any one fire)
It jQQ QQQ
MED EXP(Any one person)
$ 10,000
PERSONAL& ADV INJURY
$ 2,000,000
GENERAL AGGREGATE
$ 3,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
POLICY X PRO LOC
PRODUCTS-COMPIOPAGG
$ 3,000,000
A
AUTOMOBILE
LIABILITY
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON-OWNEDAUTOS
BAP348258901
12/31/2003
12/31/2004
COMBINED SINGLE LIMIT
(Ea accident)
$ 2,000,000
X
BODILY INJURY
(Per person)
$
X
BODILYINJURY
(Per accident)
$
X
PROPERTYDAMAGE
(Per accident)
$
GARAGE LIABILITY
ANYAUTO
AUTO ONLY - EA ACCIDENT
$
OTHER THAN EAACC
AUTO ONLY: AGG
$
$
B
EXCESS LIABILITY
X OCCUR CLAIMS MADE
DEDUCTIBLE
X RETENTION $ 1Q 0Q
BE2131444
12/31/2003
12/31/2004
EACHOCCURRENCE
$ 10 000 000
AGGREGATE
$ 10,000,000
a
$
A
A
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITYRY
THE PROPRIETOR/
PARTNERS/EXECUTIVE
ARE: INCLUDED
WC348258501
WC348258601
12/31/2003
12/31/2003
12/31/2004
12/31/2004
X WC STATU- OTH-
LIMITS
E.L. EACH ACCIDENT
$ 1,000,000
E.L. DISEASE -EA EMPLOYEE
$ 1,000,000
E.L.DISEASE-POLICYLIMIT
$ 1 000 000
OTHER
DESCRIPTION OF OPERATIONSILOCATIONSNEHICLESIEXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
Re: Contractors License
City Of Ft. Collins
300 Laporte
Ft. Collins, CO 80251
ACORD 25-S (7/97)
l/C3N3V1VRI
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE 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 INSURER, ITS AGENTS OR
C011:888237 Tpl:228264 Cart:`3898536
®ACORD CORPORATIDN 11GRA