HomeMy WebLinkAbout103009 PORTER INDUSTRIES INC - INSURANCE CERTIFICATE (14)ACORD CERTIFICATE OF LIABILITY INSURANCE OPID GG j DAn'MN'DD"""'
PORTS-1 0 02 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 Pkry ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
.Tohnatow CO 80534
lPhone:970-635-9400 Fax:970-635-9401 INSURERS AFFORDING COVERAGE NAIC#
Porter Industries, Inc.
Attn: Chery1 Kendrick
5202 Granite Street
Loveland CO 80537
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANO ING
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.
LTR
NSR
TYPE OFINSURANCE
POLICYNUMGER
VE
DATE MWODIYY
POLICY !EXPIRATION
DATCIMWDDfYYJ
LIMITS
GENERAL IAABILITY
EACH OCCURRENCE
$1,000,000
A
X COMMERCIAL GENERAL LIABILITY
CLAIMS MADE ® OCCUR
34UUNTX0464
04/30/08
04/30/09
PREMISESEaoccu _
a 300 000
MED EXP (Any one person)
$10 , 000
PERSONAL & ADV INJURY
r1,000_I.000
X Blanket Waiver _
X
Blanket AddIl Ins
AGGREGATE
$2,000,000
GEHL AGGREGATE LIMIT APPLIES PER:
_GENERAL
PRODUCTS - COMPIOPAGG
52, 000, DUD
POLICY X JECT I I LOC
Kimp Ben.
11000,000
A
AUTOMOBILE
LU1SILTTY
ANY AUTO
34UUNTX0464
04/30/08
04/30/09
COMBINED SINGLE LIMIT
(Ea acdaem)
S11000,000
X
ALL OWNED AUTOS
SCHEDULED AUTOS
BODILY INJURY
(Per Person)
$
A
A
HIREDAUTOS
NON -OWNED AUTOS
X
BODILY INJURY
(Pereccldenl)
S
X
A
Blanket Waiver
X
PROPERTY DAMAGE
(Pere dent)
S
GARAGE LIABILITY
AUTO ONLY - EA ACCIDENT
$
ANYAUTO
OTHER THAN EA ACC
AUTO ONLY: AGG
$
8
EXCESSILINDULLALIABLITY
OCCUR CLAI MS MADE
EACH OCCURRENCE
S
AGGREGATE
$
S
DEDUCTIBLE
RETENTION $
$ �^
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITYB ANY PROPRIETOF/IPARTNER/EXECUTIVE
OFFICERIMEMBER EXCLUDED?
8Ya;deectloa PROVISIONS
SPECIAL PROVISIONS below
4038253
D7/Dl/08
07/01/09
.� TORN LIMITS Eft
E. L. EACH ACC !DENT
$1 000,000
E.L. DISEASE - EA EMPLOYEE
S 1 ()D0 000
E.L. DISEASE - POLICY LIMIT
s 1 000 Do
OTHER
DESCRIPTION OF OPER&MN8I LOCATIONS f VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENTI SPECIAL PROV BIONS
All Operations - All Locations The Certificate Holder is listed as
Additional Insured in regard to the General Liability.
City of Fort Collins
Custodial Services
P.O. Box 580
Ft. Collins, CO 80524
25
CITYFT3 I SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED
DATE THEREOF,THE ISSUING INSURER PALL 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. /.
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.