HomeMy WebLinkAbout103009 PORTER INDUSTRIES INC - INSURANCE CERTIFICATE (13)ACORD„ CERTIFICATE OF LIABILITY INSURANCE POR ?- DATE6/16/08
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#
Porter Industries, Inc.
Attn: Cheryl Kendrick
5202 Granite Street
Loveland CO 80537
1R�11'Ia:I_1�f3.'1
INSURER A'. The Hartford
______--___.
INSURER 8: Pinnacol Assurance
INSURER C:
INSURER D:
INSURER E'
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 CONTRACTOR 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.
_—
POLICY EFFECTIVE POLICY EXPIRATION
LT R NSR TYPE OF INSURANCE POLICY NUMBER DATE MMIDO/YY PATE (MMIDDMI LIMITS
GENERAL LIABILITY
EACH OCCURRENCE
$1,000,000
A
X COMMERCIAL GENERAL LIABILITY
CLAIMS MADE CI OCCUR
34UUNTX0464
04/30/08
04/30/09
7AMAGETO RENTED_._
PREMISES(Eacce.ce)
s300,000
MED EXP(Any one person)
$10,000
X Blanket Waiver
PERSONAL &ADV INJURY
$1,000,000
X,Blanket
Add']. Ins
GENERAL AGGREGATE
$2,000,000
GENT AGGREGATE LIMIT APPLIES PER:
PRODUCTS - COMP/OP ADS
$2,000,000
POLICY X JECCT LOC
Emp Ben.
1,000,000
A
AUTOMOBILE
LIABILITY
ANY AUTO
34UUNTX0464
04/30/08
04/30/09
COMBINED SINGLE LIMIT
(Ea accident)
$1,000,000
X
ALL OWNED AUTOS
SCHEDULED AUTOS
---------
BODILY INJURY
(Per person)
-- _...._.
$
X
R
A
A
HIRED AUTOS
NON -OWNED AUTOS
BODILY INJURY
(Per accident)
$
A
Blanket Waiver
X
PROPERTY DAMAGE
(Per accident)
$
GARAGE LIABILITY
AUTO ONLY - EA ACCIDENT
$
ANY AUTO-
-��
OTHER THAN EA ACC
$
$
AUTO ONLY: AGG
E%CESSIUMBRELLA LIABILITY
JOCCUR r] CLAIMS MADE
EACH OCCURRENCE
S
AGGREGATE
$
$
DEDUCTIBLE
RETENTION $
g
B
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY
ANY PROPRIETOR/PARTNER/EXECUTIVE
4038253
07 / /08
Ol
07/01/09
X TORYLIMITS ER
E.L. EACH ACCIDENT
$1,000,000
OFFICERIMEMBER EXCLUDED?
Ryes, tle5ctibe Untler
EA
FL. D1.'F.ASF.-FA
61, QQQ, QQQ
ICY L..EF.
E. L. DISEASE -POLICY LIMIT
51 000,000
SPECIAL PROVISIONS below
OTHER
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS
All Operations - All Locations
City of Fort Collins
Senior Center
P.O. Box 580
Ft. Collins, CO 80524
CITYFT3 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATIO1,
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 INSURER, ITS AGENTS OR
REPRESENTATIVES.
ACORD 25 (2001108)
n
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