HomeMy WebLinkAboutMCM INC - INSURANCE CERTIFICATE (2)ACORD CERTIFICATE OF LIABILITY INSURANCE OP ID S DATE6/09I/06
MILE531 06 09 06
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
Network Insurance Services , LLC HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
7395 E Orchard Rd -Ste A400 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Greenwood Village CO 80111
Phone:303-708-9999 Fax:303-708-0202
INSURED
MCM Inc.
12649 E Caleg 1120
Centennial CD 0111
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INSURERS AFFORDING COVERAGE NAIC #
INSURER A: Bituminous Insurance Co
INSURERB: Pinnacol Assurance of CO
INSURER C:
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
POLICY EFFECTIVE
DATE MMIDD
POLICY EXPIRATION
DATE MMRDDIYY
LIMITS
GENERAL LIABILITY
EACH OCCURRENCE
-DAMAGE
$1,000 OOO
x COMMERCIAL GENERAL LIABILITY
CLAIMS MADE ® OCCUR
CLP3221004
12/01/05
12/01/06
mA
PREMISES Ea occurence
$100000
VIED EXP (Any one person)
$ 5 , 000
PERSONAL &ADV INJURY
$ 1, 000 , 000
%
Per Project
GENERAL AGGREGATE
$2,000 000
GEN'L AGGREGATE LIMIT APPLIES PER:
PRODUCTS-COMP/OP AGG
$2,000 000
POLICY JECOT LOC
Ben.
1,000,000
A
AUTOMOBILE
LIABILITY
ANY AUTO
CLP3221004
12/01/05
12/01/06
COMBINED SINGLE LIMIT
(Ea accident)
$ 10000O0
i r
BODILY INJURY
(Per person)
$
ALL OWNED AUTOS
SCHEDULED AUTOS
$
BODILY INJURY
(Per accident)
$
HIREDAUTOS
NON -OWNED AUTOS
$
PROPERTY DAMAGE
(Per accident)
$
GARAGE LIABILITY
AUTO ONLY - EA ACCIDENT
$
OTHER THAN EA ACC
$
ANY AUTO
$
AUTO ONLY: AGG
EXCESSIUMBRELLA LIABILITY
EACH OCCURRENCE
$ 5 000 , 000
A
R I OCCUR CLAIMS MADE
CUP257753
12/01/05
12/01/06
AGGREGATE
$5 000,000
$
$
DEDUCTIBLE
][ RETENTION $10 000
$
B
WORKERS COMPENSATION AND
EMPLOYERS'LIABILITY
ANY PROPRIETORIPARTNERIEXECUTIVE
4029009
07/01/06
07/01/07
is TORY LIMITS ER
E.L. EACH ACCIDENT
$ 500000
E.L. DISEASE - EA EMPLOYEE
$ 500000
OFFICER/MEMBER EXCLUDED?
Ifyes, describe under
SPECIAL PROVISIONS below
E.L. DISEASE -POLICY LIMIT
$ 500000
OTHER
A
Leased/Rented Eq
CLP3221004
12/01/05
12/01/06
$500 Ded 20,000
A
Builders Risk
CLP3221004
12/01/05 1
12/01/06
$500 Died 40,000
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES 1 EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS
♦rI'1r\ V GLL1111 V I\
CITYFOR 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
City of Fort Collins IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
PO Box 580 REPRESENTATIVES.
Fort Collins CO 80522-0580 AUTH0 &pESENTP j
ACORD 25 (2001108) (c� ACORD CORPORATION 1QRF