HomeMy WebLinkAboutCOMMERCIAL DESIGN - INSURANCE CERTIFICATE (2)ACORD CERTIFICATE OF LIABILITY
INSURANCE
5130/2 s'
PRODUCER (303)824-6600 FAX: (303)370-0118
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Moody Insurance Agency, Inc.
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
3773 Cherry Creek North Drive
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Suite 800
Denver CO 80209-3804
INSURERS AFFORDING COVERAGE
NAIC #
INSURED
INSURER A: Continental Western Ins
10804
Commercial Design, Inc.
INSURER B: Pinnacol Assurance
41190
P. O. BOX 1667
INSURER C:
NSURER D:
Ft. Collins CO 80522
INSURER E:
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING AN
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.
A TS SHOWNPAID CLAIM
INSR
ADD-LIt=
TYPE OF INSURANCE
POLICY NUMBER
PO TEYMIFAFIEU/nYYVE
POLICY
MMPUD/YYON
LIMITS
GENERAL LIABILITY
EACH OCC RRENCE
$ 1,000,000
DAMAGE TO RENTED
PREMISES Ea o pence
$ 100,000
A
X COMMERCIAL GENERAL LIABILITY
CLAIMS MADE 7X OCCUR
CWP2573774
7/1/2008
7/1/2009
MED EXP (Any one erson
$ 5,000
PERSONAL B ADV INJURY
$ 1,000,000
GENERAL AGGREGATE
$ 2,000,000
GEML AGGREGATE
LIMIT APPLIES PER:
PRODUCTS -COMPIOPAGG
$ 2,000,000
POLICY
X JECT LOC
AUTOMOBILE
LIABILITY
ANY AUTO
COMBSINGLE LIMIT
(Ee aaitlenid.nt)0
$ 1,000,000
X
BODILY INJURY
(Per person)
$
A
ALL OWNED AUTOS
SCHEDULED AUTOS
CWP2573774
7/l/2008
7/1/2009
BODILY INJURY
(Per accident)
$
HIRED AUTOS
NON -OWNED AUTOS
PROPERTY DAMAGE
(Per eccitlen0
$
GARAGE LIABILITY
AUTO ONLY - EA ACCIDENT
$
OTHER THAN EAACC
E
ANYAUTO
$
AUTO ONLY: AGO
E%CESWUMBRELLA LIABILITY
X OCCUR CLAIMS MADE
EACH OCCURRENCE
$ 5,000,000
AGGREGATE
$ 5, 000,000
$
A
DEDUCTIBLE
CU2581933
7/l/2008
7/l/2009
RPTFNTIQN
B
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY
X WC STATIT- OTH-
E.L. EACH ACCIDENT
$ 500,000
ANY PROPRIETORIPARTNERIEXECUTIVE
OFFICERIMEMBER EXCLUDED?
If yes, descnbe under
3030055
7/l/2008
7/1/2009
E.L. DISEASE EA EMPLOYE
$ 500,000
E.L. DISEASE-POUML!1MIT
500,000
SPECIAL PROVISIONS below
A
OTHER Installation
CWP2573774
7/l/2008
7/l/2009
25,000
Leased/Rented
150,000
Equipment
DESCRIPTION OF OPERATIONSILOCAnONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
Project: Fort Collins Police Services
A 10-day notice of cancellation will apply in the event of non-payment of premium. This certificate is subject to the
terms, conditions, and exclusions of the policies.
City of Fort Collins
P. 0. 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
30 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
IC Navarra, ACSR/CHANA L—-----I
ACORD 25 (2001/08)
0 ACORD CORPORATION 1988
c—. "
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) page 2 m2
INS025(oloa).o8e