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HomeMy WebLinkAboutMM PACKAGING PRODUCTS - INSURANCE CERTIFICATEAcoR V. CERTIFICATE OF LIABILITY INSURANCE OP ID P5 DATE IMMIDD VY Y) MMPAC-1 06/18/08 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Rich & Cartmill Ins of CO ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE of Colorado LLC HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR P O Box 336416 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Greeley CO 80633 Phone:970-356-8030 Fax:970-356-8032 INSURERS AFFORDING COVERAGE NAIC# INS U R E D INSURER A: St Paul Travelers 40282 MIA Packaging.Products, Inc. INSURERS Pinnacol Assurance --- ...... dba MIA Solutions and MIA Packa44].Rqq, Inc. — -- - ----- INSURERC - 3321 N. Garfield Ave Loveland CO 80538 INsuRERD INSURER E: 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 LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INS DO ____----- —---�—'— _ POLICY NUMBER POLICY €FFFCYIVE NSR POLICY EXPIRATION LIMITS LTR TYPE OF INSURANCE DATE MM/00/YY DATE MMIDD/YV GENERAL LIABILITY EACH OCCURRENCE $1,000,000 A - X COMMERCIAL GENERAL LIABILITY 660435OM507 06/18/08 06/18/09 -DAMAGETO-RENTED".._.____. PREMISES (Ea occurence) $ 100,000 CLAIMS MADE l OCCUR MED EXP (Any one person) $ 5,000 _X PERSONAL & ACV INJURY $ 1,000,000 GENERAL AGGREGATE $2, 000, 000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMPIOP AGG $ 2, 000 , O00 — � POLICY PRO- JECT — I LOG AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1000000 X A ANY AUTO BA3115L54A-08 06/18/08 06/18/09 (Ea accident) __- ALL OWNED AUTOS BODILY INJURY $ SCHEDULED AUTOS (Per person) HIRED AUTOS BODILY INJURY $ NON -OWNED AUTOS (Per accident) PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ E•XCESSIUMBRELLALIABILITY EACH OCCURRENCE $ 6000000 A fj XI OCCUR n CLAIMSMADE CUP6803Y569-08 06/18/08 06/18/09 AGGREGATE $ 6000000 $ XI X RETENTION $5000 $ WORKERS COMPENSATION AND TORY LIMITS ER B EMPLOYERS' LIABILITY 3443901 06/01/08 06/01/09 —.—._.__._. -._... ___.__ E. L EACH ACCIDENT $100000 ANY PROPRIETORIPARTNER/EXECUTIVE OFFICERIMEMBER EXCLUDED? E.L. DISEASE - EA EMPLOYEE $ 100000 If yes, describe under SPECIAL PROVISIONS be. EL DISEASE POLICY LIMIT $500000 OTHER A Property 6604350M507 06/18/08 06/18/09 Elk Limit $393,750 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION City of Fort Collins DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN Purchasing Divsion NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL John Phelan PO Box 580 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR Fort Collins CO 80522 REPRESENTATIVES. AUTHORIZED REPRESENTATIVE Shawn A Wotowe ACORD 25 (2001108) © 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. 25 f200110M