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HomeMy WebLinkAbout103009 PORTER INDUSTRIES INC - INSURANCE CERTIFICATE (11)ACORD CERTIFICATE OF LIABILITY INSURANCE OF ID RC DATE(MMIDDM ) PORTE-1 06 16 08 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE LBN Insurance Agency HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 4848 Thompson Pkwy ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Johnstown CO 80534 Phone: 970-635-9400 Fax:970-635-9401 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A: The Hartford INSURER Pinnacol Assurance Porter Industries, Inc. - _--- --- ----- ------ --- Attn: Cheryl Kendrick INSURERQ 5202 Granite Street Love Loveland CO 60537 � INSURER D: INSURER E: .1�J•la�f�l�J�O 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. INSR D'- POLICY EFFECTIVE POLICY EXPIRATION LTR NSR TYPE OF INSURANCE POLICY NUMBER DATE (MMIDD/YYI DATE MM/DD/VV LIMITS GENERAL LIABILITY EACH OCCURRENCE $1,000,000 A X COMMERCIAL GENERAL LIABILITY CLAIMS MADE X OCCUR 34UUNTX0464 04/30/08 04/30/09 O'RENTEO"'-'--- PREMISES (Ea occurence) s300,000 MED EXP (Any one person) $ 10 , 000 X Blanket Waiver PERSONAL B ADV INJURY $1,000,000 X )Blanket Addll Ins GENERAL AGGREGATE $2,000,000 GENT AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OPAGG -in $2, 000, 000 _— PRO- POLICY X JECT LOD Ben. 1,000,000 A AUTOMOBILE LIABILITY ANYAUTO 34UUNTX0464 04/30/08 04/30/09 (Ea accident) COMBINED SINGLE LIMIT $1,000,000 X ---- ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY (Per person) $ A A X X HIRED AUTOS NON -OWNED AUTOS BODILY INJURY (Per accieent) $ A X Blanket Waiver PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ ANY AUTO OTHER THAN EAACC $ $ AUTO ONLY: AGG EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR 171 CLAIMS MADE AGGREGATE $ $ DEDUCTIBLE $ RETENTION $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE 4038253 07/01/08 07/01/09 X TORY LIMITS ER ER - -- E.L. EACH ACCIDENT __$1,000,000 --- OFFIC ERIMEEXCLUDED? If yes, describeunder SPECIALPROVISIONSbelow E.L. DISEASE - EA EMPLOYEE $1,000,000 ---------- EL.DISEASE - POLICY LIMIT 1 $1,000 000 OTHER DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS All Operations - All Locations nvry CITYFT3 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 City of Fort Collins IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR P.O. BOX 580 REPRESENTATIVES. Ft. Collins, CO 80524 AUT41IWjfyRESEr1AT1j,, ww ul• /J/u w./ ACORD 25 (2001108) © ACORD 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.