HomeMy WebLinkAbout133608 ANLANCE PROTECTION LTD - INSURANCE CERTIFICATE (5)ACORD, CERTIFICATE OF LIABILITY
INSURANCE DATE,MM,°°"""'
PRODUCER (970)223-0924 FAX (970)267-2231
Colorado BW Insurance Agency, Inc.
10/16/2008
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
1075 W Horsetooth Rd, Ste 106
Fort Collins, CO 80526
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
INSURERS AFFORDING COVERAGE
NAIC #
INSURED Anlance Protection Lt
PO Box 2401
Ft Collins, CO 80522
INSURERA: Everest Indemnity Ins Co
INSURERS: Pinnacol Assurance
41190
INSURERC:
INSURER D:
INSURER E:
0
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.
[NSR
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TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
POLICY EXPIRATION
LIMITS
'4
GENERAL LIABILITY
X COMMERCIAL GENERAL LIABILITY
MADE Fx-] OCCUR
51GL000975-081
07/13/2008
07/13/2009
EACH OCCURRENCE
$ 11000,000
DAMAGE TO RENTED
PREMI.qF.q fr.CLAIMS
$ 50,000
MED EXP (Any one person)
$ 5,00
PERSONAL & ADV INJURY
$ 11000,000
GENERAL AGGREGATE
$ 2,000,000
GENT AGGREGATE LIMIT APPLIES PER:
X POLICY M PRO
JECT LOC
PRODUCTS - COMP/OP AGO
if 11000,000
AUTOMOBILE
LIABILITY
ANY AUTO
COMBINED SINGLE LIMIT
(Ea accident)
if
ALL OWNED AUTOS
SCHEDULED AUTOS
BODILY
NJ Y ODILI B
NJ
INJURY
$
HIRED AUTOS
NON -OWNED AUTOS
BODILY INJURY
(Per accident)
$
PROPERTY DAMAGE
(Per accident)
$
GARAGE LIABILITY
AUTO ONLY - EA ACCIDENT
$
ANY AUTO
OTHER THAN EAACC
$
AUTO ONLY: AGO
$
EXCESS/UMBRELLA LIABILITY
OCCUR a CLAIMS MADE
EACH OCCURRENCE
$
AGGREGATE
$
DEDUCTIBLE
RETENTION $
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY
4064145
O1/O1/2008
61/01/2009
X WC
W$1,000,000
E.L. EACH A0,000II
B
ANY OFFICEOPRIETEREXCLNERIEECUTIVE
yes, describs underE.L.
PROVISIONS below
OTHER
DISEASE00.000SPECIAL
E.l, DISEASE00, 000
DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT/ SPECIAL PROVISIONS
he certificate holder is named as an Additional Insured with respect to the ongoing operations
f the Named Insured on the General Liability only.
City of Fort Collins
Finance & Purchasing Department
Attn: Christine Jarvis
215 N. Mason St., Second Floor
PO Box 580
Fort Collins, CO 80522-0580
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL
30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,
BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY
OF ANY KIND UPON THEANSURER, ITS AGENTS OR REPRESENTATIVES,
AUTHORIZED REPRESENTA$'IVE' ,. n
ACORD 2512001/O81 FAX: 221-6707
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.
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