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HomeMy WebLinkAboutEXCEL SHEET METAL EXCEL BRIDGE MANUFACTURING - INSURANCE CERTIFICATE (2)ACORD. CERTIFICATE OF LIABILITY INSURANCE 08/0 /2 o) PRODUCER (714) S69-2700 FAX (714) 569-3099 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Pridemark-Everest Insurance Services, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE A Leavitt Group Co #OF13098 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 1820 E. First Street, Ste SOO Santa Ana, CA 9270S INSURERS AFFORDING COVERAGE NAIC # INSURED DBA: Excel Bridge Manufacturing Co 12001 Shoemaker Avenue Santa Fe Springs, CA 90670 101e1TA 4:7_TC1 *' INSURERA: Hartford Ins INSURER B: 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. INSRADD' rypE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE (MMIDDIYYI POLICY EXPIRATION DATE fMMfDDIYY1 LIMITS GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED PREMISES (F, $ CLAIMS MADE ❑OCCUR MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ JECT LOC POLICY PRO El AUTOMOBILE LIABILITY ANY AUTO COMBINED SINGLE LIMIT (Ea accident) $ ALL OWNED AUTOS SCHEDULED AUTOS (Per PerINJURY Person) $ HIRED AUTOS NON -OWNED AUTOS BODILY INJURY (Per accident) E �) �j PROPERTY DAMAGE (Per accident) E GARAGE LIABILITY ANY AUTO 7T RIS IVlf�N A.UbI %NT AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC $ AUTO ONLY: AGG E EXCESSIUMBRELLA LIABILITY OCCUR CLAIMS MADE EACH OCCURRENCE $ AGGREGATE $ DEDUCTIBLE RETENTION $ $ WORKERS COMPENSATION AND 34WE082569 09/01/2006 08/01/2007 WCSTATU- OTH- I EMPLOYERS' LIABILITY E.L. EACH ACCIDENT $ 1,000,000 A ANY PROPRIETOR/PARTNERIEXECUTIVE OFFICER/MEMBER EXCLUDED? If yes, describe under E.L. DISEASE- EA EMPLOYEE E 1, 000, 00 E.L. DISEASE - POLICY LIMIT I $ 1,000,00 SPECIAL PROVISIONS below OTHER DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS 10 days notice of cancellation for nonpayment of premium e: Pleasant Valley Trails City of Fort Collins P.O. Box S80 215 Madison St. Fort Collins, CO SOS22 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 MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER ITS AGENTS OR REPRESENTATIVES. AUTHORED REPRESENTATIVE ���� Gary Wells/DOCRAV AGUKIJ ZO (ZUUT/UU) ©ACORD CORPORATION 1988 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. AVVKLI W tzuul fun)