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HomeMy WebLinkAboutHRH FOSTER FRAMES - INSURANCE CERTIFICATE*HRH h I I b rogal & hobbs" August 3, 2005 To All Certificate Holders Insured Name: Policy Number: Policy Description: Insurance Company To Whom It May Concern: Foster Frames, Inc. CA00000533102 General Liability Admiral Insurance Company Please be advised that the above referenced. Policy is to be cancelled by Admiral Lnsurance Company for non-payment of premium Effective 8/15/05 at 12:01 AM. This will serve as notice, per the attached Certificate of Insurance issued from our office, as required. Should there be any questions, please contact our office. Sincerely, HR,FI o�'Colorado Richard G. Daggett, CPCU Senior Vice President TLR/752260 720 S. Colorado Blvd., Ste, 60ON P.O. Box 469025 Denver, CO 80246 303-722-7776 303-722-8862 w .hrh.com ACORU. CERTIFICATE OF LIABILITY INSURANCE ) 0DATE 7/06! 5D PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION HRH of Colorado ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 720 S. Colorado Blvd Ste 600-N HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. P.O. Box 469025 Denver, CO 80246-9025 INSURERS AFFORDING COVERAGE NAIC # INSURED INSURERA: Admiral Insurance Company 44318 Foster Frames, Inc. INSURER B: Safeco Insurance Company (Surety) 24740 8795 Ralston Road, Suite 270 INSURERC: Pinnacol Assurance 10780 Arvada, CO 80002 INSURER D: INSURER E: Cr1VPRAl:PR 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. IN3R LTR WILY NSR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE ATE MWD POLICY EXPIRATION DATE IMIM/DD/YYI LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS MADE 5_1 OCCUR CA00000533102 07/08/05 07/01/06 EACH OCCURRENCE s2,000,000 DAMAGE TO RENTED SEr cc $50 000 MED EXP (Any one person) sEXCLUDED PERSONAL& ADV INJURY $1 000 000 GENERAL AGGREGATE s2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY jE O- LOC PRODUCTS - COMPIOP AGG $2 000 000 B AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS 01CG6099892 07108105 07/01/06 COMBINED SINGLE LIMIT (Ea accident) $1,000,000 X BODILY INJURY (Per person) $ X BODILY INJURY (Per accident) $ X PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY ANY AUTO AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC AUTO ONLY: AGG $ $ EXCESS/UMBRELLA LIABILITY OCCUR CLAIMS MADE DEDUCTIBLE RETENTION $ EACH OCCURRENCE $ AGGREGATE $ a $ $ C WORKERS COMPENSATION AND ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? If yes, describe under SPECIAL PROVISIONS below 3355897 07/01/05 07/01/06 WC STATU- 'FR X I E.L. EACH ACCIDENT $1,000000 E.L. DISEASE - EA EMPLOYEE S1,000,000 E.L. DISEASE - POLICY LIMIT $1,000,000 OTHER DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT/ SPECIAL PROVISIONS " The following cancellation conditions always apply- - 10 days for non-payment of premium - If policy shown, 10 days for Workers' Compensation for fraud; material misrepresentation; non-payment of premium; other reasons approved by the Commissioner of Insurance City of Fort Collins P.O. Box 580 Fort Collins, CO 80522 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL An* 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 AGUKIJ Z5 (ZUU1/U8) 1 of 2 #M257021 TLR © AGOKU C,UKPUKA I IUN 1958 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-S (2001108) 2 of 2 #M257021