HomeMy WebLinkAboutMLS AIR CONDITIONING INC - INSURANCE CERTIFICATECl7cnt#• 17181
MI AAI
ACORD,,., CERTIFICATE OF LIABILITY
INSURANCE
DAT2ao8E (/08OYYYY)
oa/
PRODUCER
THIS CERTIFICATE 15 ISSUED AS A MATTER OF INFORMATION
Flood & Peterson Insurance Inc
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
4821 Wheaton Drive
P O Box 270370
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
_
Fort Collins, CO 80527
------
INSURERS AFFORDING COVERAGE
NAIC#
N..._..___._._.__....__
INSURED......
SURED
MLS Air Conditioning Inc.
546 8th St S.E. #Bldg. B, Suite 6
Loveland, CO $0537.6455
(NSURERA; Auto -Owners Insurance Group
INSURERFI; Pinnacol Assurance
INSURER C:
INSURERD:
INSVRERE:
COVERAGES
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 LIM[FS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INS
LTR
NBR j
TYPE OF INSI)RANCE
_.._.
POLICY NUMBER
POLICY EFFECTIVE
DATE MMIDO/YY
POLICY EXPIRATION
DATE�IDpIYY),.
.,__.. LIMITS_
A
GENERAL LIABILITY
0546327400195408
04/27/08
04/27/09
EACH OCCURRENCE
$1 000 000
X COMMERCIAL GENERAL LIABILITY
_ :] CLAIMS MADE a]OCCUR
DAMAGE
: TO RENTED
PREM6 ' F ocxorrencel _
5300 OOO
MCI) EXP (Any one person)
S1 O OOO
PERSONAL fl ADV INJURY
_
GENERAL AGGREGATE
_$1i0OgLgqq-_
s2 OOO 000
GENT. AGGREGATE LIMIT APPLIES PER:
PRODUCTS - COMP/OP AGO
$2000000
POI.ICV PRO-
JECT__ _._. LOC__
A
AUTOMOBILE
X
LIABILITY
ANY AUTO
4639984902
04/27/08
04/27/09
COMBINED SINGLE LIMIT
(Ea accident)
$1,000,000
BODILY INJURY
(Per person)
$
ALL OWNED AUTOS
SCHEDULED AUTOS
_X
X
HIREUAU'(OS
NON OWNED AV70S
BODILY INJURY
(Per accid)enl
$
X
Drive Other Car
-AGE
(Perw PROPERTY DAMAGE
(Per arcidenl)
$
--
GARAGE LIABILITY
_
AUTO ONLY- EA ACCIDENT
$
OTHER THAN FA ACC
$
ANY AUTO
$
__.._— -`—
AUTO ONLY; AC,G
EXCESS/UMBRELLA LIABILITY
OCCUR CLAIMS MADE
____
EACH OCCURRENCE
$
AGGREGATE
$
_-
$_
DEDUCTIBLE
A
B
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY
ANY PROPRIEfORIPARTNENEXECUTIVE
41O47O8
10/01/07
10/01/08
)( TWCSTAU 5,0
EL EACH ACCIDENT
$1,000,000
E.L. DISEASE - EA EMPLOYE
$1,000,000
OFFICERUMEMBER EXCLUDED?
Has, describe under
IS FOAL PROVISIONS beloe
_
-'
E.L, DISEASE -POLICY LIMIT'
$1,000,000
OTHER
I
DESCRIPTION OF OPERATIONS LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT! SPECIAL PROVISIONS
City of Fort Collins
PO Box 580
Fort Collins, CO 80522
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 00 SO SHALL
IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
AUTHORIZED REPRESENT TIVE
ACORD 25 (2001108) 1 of 2 #M413407
17Q 0 ACORD CORPORATION
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.