HomeMy WebLinkAboutTOP GUN - INSURANCE CERTIFICATE (6)ACORD TOOP GU CERTIFICATE OF LIABILITY INSURANCE PGU -1 D 11 04 DATE (MMIDDIYYYY05)
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Brown 6 Brown Inc - Ft Collins ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
125 S Howes, 5th Floor HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
P O Box 2226 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Fort Collins CO 80522-2226
Phone:970-482-7747 Fax:970-484-4165
SOU W 67th ssure Washing Inc.
St
Loveland CO 80538
V V V CKAVr-*
INSURERS AFFORDING COVERAGE
NAIC #
INSURER A: Pinnacol Assurance
INSURERS: AUTO OWNERS INS CO,
18988
INSURER C: Wellington Specialty Ins Co
INSURER D:
INSURER E:
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
DATE MMIDE TIV
RATIOR
DATE MMIDDIYY
LIMITS
GENERAL LIABILITY
EACH OCCURRENCE
$ lOOOOOO
C
X COMMERCIAL GENERAL LIABILITY
CLAIMS MADE X❑ OCCUR
PENDING
11/04/05
11/04/06
tU
PREMISES HENI rence)
$ 50000
MED EXP(Any one person)
$ 1000
PERSONAL B ADV INJURY
$ 1000000
GENERAL AGGREGATE
$ 2000000
GEN'L AGGREGATE LIMIT APPLIES PER:
PRODUCTS-COMP/OP AGG
s2000000
POLICY PROJECT LOC
B
AUTOMOBILE
LIABILITY
ANY AUTO
PENDING
10/31/05
10/31/06
CO accint)
(Eaamident) eLE LIMIT
$ 1r r 000 DDD
X
ALL OWNED AUTOS
SCHEDULED AUTOS
BODILY INJURY
(Per person)
$
HIRED AUTOS
NON -OWNED AUTOS
BODILY INJURY
(Per accident)
$
PROPERTY DAMAGE
(Per amident)
$
GARAGE LIABILITY
AUTO ONLY - EA ACCIDENT
$
ANY AUTO
OTHER THAN EA ACC
$
$
AUTO ONLY: AGG
EXCESSIUMBRELLA LIABILITY
OCCUR CLAIMS MADE
EACH OCCURRENCE
$
AGGREGATE
$
DEDUCTIBLE
RETENTION $
$
A
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY
ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICER/MEMBER EXCLUDED?
If yes, describe Under
S
SPECIAL PROVISIONS below
4031609
07/01/05
07/01/06
X I TORY LIMITS I I ER
E.L._ EACH ACCIDENT
E.L. DISEASE - EA EMPLOYEE
$ 500000
$ 500000
E.L. DISEASE - POLICY LIMIT
$500000
OTHER
B
Equipment Floater
PENDING
10/31/05
10/31/06
Leased Eq 100000
Ctr Eq 131421
DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS
FTCCITY SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN
City of Fort Collins NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
Purchasing Department
580
PO Box 580 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
Fort Collins CO 80522 REPRESENTATIVES.
AUTACfIZED REPRESENTXrVE--.-, \ ,
25 (2001/08) ACORD CORPORATION PARR