HomeMy WebLinkAboutFIRE DETECTION SYSTEMS - INSURANCE CERTIFICATEACORQ, CERTIFICATE OF
LIABILITY INSURANCE OP ID RC
DATE(MM/DD/YYYY)
1
FIRED-1
09 12 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: Safeco Insurance Companies
24740
INSURER B: Pinnacol Assurance
Fire Detection Systems LLC
INSURER C: Everest Indemnity Ins company
1351 West 121st Ave.
INSURER D:
Westminster CO 80234--
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INCI IRFR F
.:UVtKACitJ
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
LTR
ABD'q
1, NERO.
-
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
DATE MM/DDII'Y
POLICYEXPIRATION
DATE MMIDD/YV
-----
LIMITS
GENERAL LIABILITY
EACH OCCURRENCE
$1,000,000
C
X COMMERCIAL GENERAL LIABILITY
51GL003337
09/15/08
09/O1/09
-PREMI ES( RENTED-- "—'
PREMISES ([a ocwrence)
$SD, DDD
.,_ CLAIMS MADE .. OCCUR
LIED EXP (Any one person)
s5,000
PERSONAL & ADV INJURY
$1,000,000
X Blanket Waiver
X Blanket Add'l Ins
GENERAL AGGREGATE
s2,000,000
GEHL AGGREGATE LIMIT APPLIES PER:
PRODUCTS COMP/OP AGG
$2,000,000
Pf20-
17
.._....... ___
_.__...
POLICY JECT LOG
AUTOMOBILE
LIABILITY
COMBINED SINGLE LIMIT
$1,000,000
ANYAUI'O
OICG400105
09/01/08
09/01/09
(Ea accident)
ALL OWNED AUTOS
BODILY INJURY
A
X
SCHEDULED AUTOS
(Per person)
X
HIRED AUTOS
BODILY INJURY
X
NON -OWNED AUTOS
(Per accident)
$
PROPERTY DAMAGE
$
(Per accident)
GARAGE LIABILITY
AUTO ONLY - EA ACCIDENT
$
ANY AUTO
OTHER THAN EA ACC
$
$
AUTO ONLY: AGG
EXCESSIUMBRELLA LIABILITY
EACH OCCURRENCE
s2,000,000
C
X„J OCCUR _J CLAIMSMADE
15CCO01085
09/15/08
09/01/09
AGGREGATE
$2, 000, 000
S
$
DEDUCTIBLE
RETENTION $
$
WORKERS COMPENSATION AND
AS
B
EMPLOYERS' LIABILITY
4073320
09/01/08
09/01/09CIDENT
FEA
$1,000,000
ANY PROPRIETORIPARTNERIEXECUTIVE
$ 1,DDO,DDO
OFFICER/MEMBER EXCLUDED?
if yeS, dcce,ILoo ,:
SPECIAL PROVISIONS below
-Pv^LIC'/LPJIT
$1 000,000
OTHER
A
Property
OICG400105
09/01/08
09/01/09
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS
Alarm Service & Testing
CERTIFICATE HOLDER CANCELLATION
CTYFTCO 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 Ft. Collins IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
P.O. BOX 580 REPRESENTATIVES.
Ft. Collins CO 80522 AUT IWAE?RESEy;fATIVEE _ w
ACORD 25120011081 n AcnRn nnaanaATlnM 10AP
II'et W 'M,
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.