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Home My WebLink About107374 SIGNS NOW - INSURANCE CERTIFICATECERTIFICATE OF INSURANCE T ' t ® STATE FARM FIRE AND CASUALTY COMPANY, Bloomington, Illinois STATE EARM ❑ STATE FARM GENERAL INSURANCE COMPANY, Bloomington, Illinois ❑ STATE FARM FIRE AND CASUALTY COMPANY, Scarborough, Ontario INSURANCE ❑ STATE FARM FLORIDA INSURANCE COMPANY, Winter Haven, Florida i L❑ STATE FARM LLOYDS, Dallas, Texas insures the following policyholder for the coverages indicated below: Name of policyholder THOMAS/SIGNS NOW, INC. Address of policyholder Location of operations Description of operations 2005 S. COLLEGE AVENUE, FORT COLLINS, CO 80525 3820 W. 10 ST. GREELEY, CO & 2005 S. COLLEGE AVENUE, FORT COLLINS, CO & 6848 S. UNIVERSITY BLVD, CENTENNIAL COLORADO The policies listed below have been issued to the policyholder for the policy periods shown. The insurance described in these policies is subject to all the terms exclusions, and conditions of those Dolicies. The limits of liabilitv shown may have heen reEinmad by any naid cinims POLICY NUMBER TYPE OF INSURANCE POLICY PERIOD Effective Date ; Expiration Dais LIMITS OF LIABILITY (at beginning of policy period) 96-CZ-9646-lF Comprehensive 04/01/05 04/01/07 BODILY INJURY AND - ---------------------------- Business Liability ---------------------------- PROPERTY DAMAGE This insurance includes: ------------------------------------- ® Products - Completed Operations ® Contractual Liability ® Underground Hazard Coverage Each Occurrence $ 1, 000, 000 ® Personal Injury ® Advertising Injury General Aggregate $ 2, 000, 000 ® Explosion Hazard Coverage ® Collapse Hazard Coverage Products - Completed $ 2, 000, 000 ❑ Operations Aggregate POLICY PERIOD BODILY INJURY AND PROPERTY DAMAGE EXCESS LIABILITY Effective Date ; Expiration Date (Combined Single Limit) 96-CY-2990-0 ® Umbrella Each Occurrence $ 1, 000, 000 03/24/97 04/01/07 ❑ Other Aggregate $ Part 1 STATUTORY Part 2 BODILY INJURY Workers' Compensation and Employers Liability Each Accident $ Disease Each Employee $ Disease - Policy Limit $ POLICY NUMBER TYPE OF INSURANCE POLICY PERIOD Effective Date ; Expiration Data LIMITS OF LIABILITY (at beginning of policy period) ..gym I ,rwn r c yr EnaUF%AN%,C w Nv I A L VN I KA(: i Ur iNSUKANUE AND NEITHER AFFIRMATIVELY NOR NEGATIVELY AMENDS, EXTENDS OR ALTERS THE COVERAGE APPROVED BY ANY POLICY DESCRIBED HEREIN. * AND CONTINUOUS UNTIL CANCELLED If any of the described policies are canceled before its expiration date, State Farm will try to mail a written notice to the certificate holder 30 days before Ilation. I�er, ail to mail such notice, n bligation or liab ity 11 be imposed on State Name and Address of Certificate Holder F or its aaen rBo s tatives _ CITY OF FORT COLLINS P.O. BOX 580 FORT COLLINS, COLORADO 80522 ATTN: ED BONNETTE CITY OF FORT COLLINS PURCHASING FAX #221-6707 SW994 a.3 04-1999 Printed in U.S.A. Agent's Code Stamp AFO CIMAD`� D. BISCHOFF Sta a arm Insurance 1300 Oakridge Drive, Suite 100 Fort Collins, Colorado 80525 (970)223-9400 CERTIFICATE OF INSURANCE TFIiShat ® STATE FARM FIRE AND CASUALTY COMPANY, Bloomington, Illinois sse:e :FRa: I. ❑ STATE FARM GENERAL INSURANCE COMPANY, Bloomington, Illinois ,-, ❑STATE FARM FIRE AND CASUALTY GOMPANY, Scarborough, Ontario ❑STATE FARM FLORIDA INSURANCE COMPANY, Winter Haven, Florida CKSURA\C_ ❑ STATE FARM LLOYDS, Dallas, Texas insures the following policyholder for the coverages indicated below. Name of policyholder TROMAS/SIGNS Now, INC. Address of policyholder 2005 S. COLLEGE AVENUE, FORT COLLINS, CO 80525 Location of operations 3820 W. 10 ST. GREELEY, CO & 2005 S. COLLEGE AVENUE, FORT COLLINS, CO Description of operations & 6848 S. UNIVERSITY BLVD, CENTENNIAL COLORADO The policies listed below have been issued to the policyholder for the policy periods shown. The insurance described in these policies is subject to all the terms exclusions, and conditions of those policies. The limits of liability shown may have been reduced by any paid claims. POLICY PERIOD LIMITS OF LIABILITY POLICY NUMBER TYPE OF INSURANCE Effective Data ;Expiration Date (at beginning of policy period) 96-Cz-9646-1F Comprehensive 04/01/05 04/01/07 BODILY INJURY AND Business Liability --------------------------- PROPERTY DAMAGE -------- This insurance indudes: �---------------------------------- ® Products - Completed Operations ® Contractual Liability ® Underground Hazard Coverage Each Occurrence $1, 000, 000 ® Personal Injury ® Advertising Injury General Aggregate $ 2, 000, 000 ® Explosion Hazard Coverage ® Collapse Hazard Coverage Products - Completed $ 2, 000, 000 ❑ Operations Aggregate POLICY PERIOD BODILY INJURY AND PROPERTY DAMAGE EXCESS LIABILITY Effective Date : Expiration Date (Combined Single Limit) 96-CY-2990-0 ® Umbrella 03/24/97 04/01/07 Each Occurrence $ 1, 000, 000 ❑ Other Aggregate $ Part 1 STATUTORY Part 2 BODILY INJURY Workers' Compensation and Employers Liability Each Accident $ Disease Each Employee $ Disease - Policy Limit $ POLICY NUMBER TYPE OF INSURANCE POLICY PERIOD Effective Date ; Expiration Date LIMITS OF LIABILITY (at beginning of policy period) THE CERTIFICATE OF INSURANCE IS NOT A CONTRACT OF INSURANCE AND NEITHER AFFIRMATIVELY NOR NEGATIVELY AMENDS, EXTENDS OR ALTERS THE COVERAGE APPROVED BY ANY POLICY DESCRIBED HEREIN. " AND CONTINUOUS UNTIL CANCELLED If any of the described policies are canceled before its expiration date, State Farm will try to mail a written notice to the certificate holder 30 days before �n i;ibatn. Zu rd r to mail such notice, n bligation liabiG bfail imposed h State Name and Address of Certificate Holder F or its aaents o e tives. CITY OF FORT COLLINS P.O. BOX 580 FORT COLLINS, COLORADO 80522 ATTN: ED BONNETTE CITY OF FORT COLLINS PURCHASING FAX #221-6707 558-994 11.3 04-1M Printed in U.SA. Agent's Code Stamp BRADLEY D. BISCHOFF AFO Code MUFarm Insurance 1300 Oakridge Drive, Suite 100 Fort COMB, Colorado 80526 (970) 223-9400 z•d d1E:z0 90 Ea unC y S J „CZ9TATE FARM INSURANCE COMPANIES Lwsuxanu: llcy ll_ I3ischuEF Agency 1300 O,Aridge Drive, Suite 100 Fort Collins, (L) 80525 0) 0) 221-9 400 Fk,s (9 70) 223-13013 ( ill free• 888- -19 1i.58 T'.tnail YOTAI. PA61-.S 1311"ING SEN- T INCLUDING COYFIR Si I F I"T 2 TO: (;11'Y OF FOR"T COI,LINS PLRCIIASINGIN',PAR'I`i%J[iN- T ATFN: fMR. Fl) BONN1I1"H" FAX: 221-6707 I)A'1'1:: !C'NII 23, 2006 TI MI 2:')0 P. M. FW )NI: Kell. Schlager FANIAIL: kellE.(I.schla=r.ioe7!ii`statefarm.com lZFAA.sRI?NCE: A'ITAC1.IE D IPI3'1'h,'T1IO. MAS 1:)13A SI(.iNS NOW Dear Mr. 'Bonncttc, Please see attached the Certificate of Insurance that you had requested for Pete 'Thomas DBA Signs Now. Please note:, however, that the :Additional Insured I' idorsement that you had requested as well will have to be issued by my Regional Office so you should sec that documentation within the week. I lowever, if you should have any questions, comrricnts or concerns in regards to this paperwork, please feel free to give me a call. Sincerely, Kelly Schlag er, I NA5 Brad Bischoff Agency S'T:ATI ; FARM INSURANCI? COMPANIliS T•d d06:20 90 62 unr Administrative Services Purchasing Division facsimile transmittal To: Kelly — State Farm Insurance Fax: 223-3393 From: Ed Bonnette — City of Fort Date: 6/23/2006 Collins Purchasing Re: Certificate of Liability Pages: 1 + cover Insuratwe for Signs Now (Pete Thomas) k here and type name] ❑ For Review ❑ Please Comment X Please Reply ❑ Please Recycle ti Celly, Here is an example of the Certificate of Liability Insurance form I am looking for, for Signs Now (Pete Thomas). Note on the bottom where it says "City of Fort Collins is an additional insured as required by written contract" And under Certificate Holder, it lists our mailing address. Would you please fax me a similar form for Signs Now? We have given them the contract to make signs for advertising at the EPIC Recreation Center, so they will be doing work for us on -site there. Please fax the form over to me at 221-6707. If questions, please call me at 416-2247. 5 &,-� ............................ 215 North Mason Street • 2nd Floor • P.O. Box 580 • Fort Collins, CO 80522-0580 • (970) 221-6775 • FAX (970) 221-6707 Server 6/14/'LOUb U:IJ AM PAUL •L/UU'G Pax Server ACORM CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDPrYY) 11/03/2005 06/14/2005 - PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION �� Camp p ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 444 W.471h Street, Suite 900 HOLDER, THIS CERTIFICATE DOES NOT AMEND, EXTEND OR KansasQyMoOWV906 LT..ERTHEGZNfRAGI=_AF-EORDf&5YTH1tPQLICIES_aE KW. (816)9609000 INSURERS AFFORDING COVERAGE INSURED UNITED SITE SERVICES INWIKWA. LIBEM MUTUALFME INS.CO.-KC INSURER B'. AMERICAN GUARANTEE& L *** I t15I643 FA, BOX 219 INSURER ***INSURANCE CO.-ZURICH COMMERCE CITY CO80037 ..ten rrl.Trern� vn THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDMION 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. AGGREGATELIMITS SHOWN MAY HAVE 13EEN REDUCED BY PAID CLAIMS. I S TYPE OF INSURANCE POLICY NUMBER D LMCYEPmVlYY DATE MMIODra LIMITS A GENERAL UA9IU7Y X COMMERCIALGENERALLIAmrrY CLAIMSMADE FX OCCUR CONTRACTUALO= RG2641435338024 11/03/2004 11/0312005 EAW OCCURRENCE 5 Igo 000 FIREOAMAGE aePrc $ 100000 MED EXP AA one arson ; SO Ow IR§PNAL6ADVINJURY ; 1000000 - POI.LLITION .-_ GENERAL AGGREGATE `+ 2000000 6 2000000 GV4CAGGREGATELUITAPPLIESPER: POLICY 0 JPRO EC FIZODUCYS. CC14PIOPAGG A AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUT03 NON -OWNED AUTOS A32641435338034 11/03/2004 11/03/2005 (COM8INleFJ arySMGLEL@tIT rdden ; 2OOpr00Q X BODILY INJURY (per Perron) ' X IINJURY (Prory sccWere) 9 X7pp(j X PROPERTYDAMAGE (Per awideM) OARAGEUABA.rYY ANY AUYO NOT APPLICABLE AUTO ONLY - EAACCIDENT OTHER THAN EAAccAVTOONLY: OEXCESS *5,000ax0000 B LIABILITY X OCCUR CLAIMS MADE UYBREIIA DEDUCYIELE FOBI RRETENTION AUC427541600 11/03/LOO4 11/03/2005 EACH OCCURRENCE AGGREG E 6 9 i� _ �_ i A WORKERS COMPENSATION AND EMPLOYERS• LIABILITY WA764D435338014 11/03/2004 11/03/2005 X T E.L, SACH ACCIDENT ,- 6 1,OOQ000 E.LOISEAS -EAEMPL YEE E,L. DISEASE-PCLICY LIMIT 4 I OOO OQO OTHER Di{6CINPTION OF OPERAMONSILOCATIONSNEHCLMWXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS OITY OF FORT COLLINS IS AN ADDITIONAL INSURED AS REQUIRED BY WRETT'EN CONTRACT. HOLDER o1 S NSUR6NCELLATION Isi7sm SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BB CANCELLED BEFORE THE UPIRA'RN WD CITY OFF0KrCONS DATE THEREOF, THE ISSUING INBUNAWILL9NDEAVOR TO MAIL 30 . DAYS WRITTEN PO BoX sm NDYICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,RM FAILURE TO 00 60 SHALL FORT COW NS C060522 IMPOSE NO OBLIGATION OR LIABILITY OF AVY KIND UPON THE INSURER, ITS AGENTS OR REPIftENTATNES, AUTHORM90 REPRESENTATIVE ACORD25-S(71071 Nraw/:.,.r,..eodI,gIhIswal lo,cormrlln rrMIgflawl�u.•roee�oeWfloneeow,rMfp,,Nyw.0Wft"e.•UNINEZ. e�ORD PORATONIs" a •d aavi•0N PLO :s OOOa ll'unr