HomeMy WebLinkAbout125353 SAFE SYSTEMS INC - INSURANCE CERTIFICATE (4)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 RED ED BY PAID CLAIMS,
INSR
ADD1
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
DATE MMIDDIYY
POLICY EXPIRATION
DATE MMIDD/VY
LIMITS
GENERAL LIABILITY
EACH OCCURRENCE
$ 1,000,000
A
X COMMERCIAL GENERAL LIABILITY
CLAIMS MADE a OCCUR
BSPKG2059903
10/1/2007
10/1/2008
DAMAGE TO RENTED
PREMI'E Ea occurrence
$ 100,000
MEDEXP An one person)$
51000
PERSONAL B ADV INJURY
$ 11000,000
GENERAL AGGREGATE
$ 2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
POLICY PRO-
JECT LOC
PROD T -C P/OPA G
$ 2,000,000X
AUTOMOBILE
LIABILITY
ANY AUTO
(EeaaDl'INGLE LIMIT
cide
$ 1,000,000X
X
BODILY INJURY
(Per person)
$
B
ALL OWNED AUTOS
SCHEDULED AUTOS
CPPOS7227201
10/1/2007
10/1/2008
BODILY INJURY
(Per accident)
$
HIRED AUTOS
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
$ 81000,000
AGGREGATE
$ 81000,000
X OCCUR CLAIMS MADE
$
C
DEDUCTIBLE
XLS0037367
10/1/2007
10/1/2008
RETENTION
D
WORKEREMPLOYSCOMPBILITY ON AND
EMPLOYERS' LIABILITY
X T�RYIIMIT OTH.
ER_
EA. EACH ACCIDENT
$ 100,000
ANY PROPRIETOR/PARTNEWEXECUTIVE
OFFICER/MEMBER EXCLUDED?
It yes, describe under
1747952
4/1/2008
4 1 2009
/ /
E.L. DISEASE-EAEMPLOYEE
$ 100,000
E L DISEASE POLICY LIMIT
$ 500,000
SPECIAL PROVISIONS beII
OTHER
DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLESIEXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
City of Fort Collins
Attn. Accounts Payable
PO Box 580
Fort Collins, CO 80522
4CORD 25 (2001108)
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL
10 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
AUTHORIZED REPRESENTATIVE
D B011man CIC ARM/CLA
C) ACORD CORPORATION 1 QRR
INSU25 (o1o8). oaa Page 1 of 2
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 (2001108)
INS025 (olospan Pa9e 2 d 2