HomeMy WebLinkAboutALLISERT CONCEPTS - INSURANCE CERTIFICATECERTIFICATE OF LIABILITY INSURANCE
American Family Insurance Company ❑
American Family Mutual Insurance Company if selection box is not checked.
6000 American Pky Madison, Wisconsin 53783-0001
Insured's Name and Address Agent's Name, Address and Phone Number (Agt./Dist.)
Allisert Concepts LLC Daniel B Richmond (970) 484-2881
1624 s Whitcomb St 923 E. Prospect Rd
Fort Collins, CO 80526 Fort Collins, CO 80525-1110 (005/316)
This certificate is issued as a matter of information only and confers no rights upon the Certificate Holder.
This certificate does not amend, extend or alter the coverage afforded by the policies listed below.
COVERAGES
This is to certify that policies of insurance listed below have been issued I,, the insured named above for the policy period indicated, notwithstanding any requirement, term or condilion 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.
TYPE OF INSURANCE
POLICY NUMBER
DAE
LIMITS OF LIABILITY
EFFECTIVEL)CY EXPTIRATION
Mo Day, Yr(Mo. Cry. Yr
Homeowners/
Bodily Injury and Property Damage
Mobilehomeowners Liability
Each occurrence $ '000
Boatowners Liability
Bodily Injury and Property Damage
Each Occurrence $ .000
Personal Umbrella Liability
Bodily Injury and Property Damage
Each Occurrence $ '000
Farm/Ranch Liability
Farm Liability &Personal Liability
Each Occurrence $ ,000
Farm Employer's Liability
Each Occurrence $ 000
Workers Compensation and
Statutory
Employers Liability t
Each Acclderil $ ,000
Disease - Each Employee $ ,000
Disease - Policy Limit $ '000
General Liability
General Aggregate $ 2,000 000
® Commercial General
Liability (occurrence)
❑
05-XG81 85-01 -00
2/11/2008
2/17/2009
Products- Completed Operations A regale $ 2,000 ,000
Personal and Advertising Inu $ 1,000
Each Occurrence $ 1.000 ,000
❑
Damage to Premises Rented to You $ 100 000
Medical Expense (Any One Person) $ 5 000
Businessowners Liability
Each Occurrencet t $ ,000
Aggregatett $ ,000
Liquor Liability
Common Cause Limit $ '000
Aggregate Limit $ '000
Automobile Liability
El Any AVID
Bodily Injury- Each Person $ ,000
❑ All Owned Autos
❑ Scheduled Autos
❑ Hired Auto
Bodily Injury - Each Accident $ '000
Properly Damage $ ,000
❑ Nonowned Autos
❑
Bodily Injury and Property Damage Combined $ '000
Excess Liability
❑ Commercial Blanket Excess
❑
Each occurrence/Aggregate $ 000
Other (Miscellaneous Coverages)
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/RESTRICTIONS /SPECIAL ITEMS t The individual or partners shown as insured Have ❑Have not
elected to be covered as employees under this policy.
t t Products Completed Operations aggregate is equal to each
occurrence limit and is included in policy aggregate.
CERTIFICATE HOLDER'S NAME AND ADDRESS
CANCELLATION
• City of Fort Collins
Y
P O Box 580
Fort Collins Cc 80522
Should any of the above described policies be cancelled before the
expiration date thereof, the company will endeavor to mail*( 10 days)
written notice to the Certificate Holder named, but failure to mail such
notice shall impose no obligation or liability of any kind upon the
cogpany, its agents or representatives. " 0 days unless different
number of days shown.
❑ This certifies coverage on the date of issue only. The above
described policies are subject to cancellation in conformity with their
terms and by the laws of the state of issue.
DATEISSUED
AUTHORIZED REPRESENTATIVE
8/12/2008
U-201 Ed. 5/00 Certificate Holder / V / Stock'No. 06668 Rev. 7/02