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HomeMy WebLinkAboutSECURITY DOCUMENT DESTRUCTION - INSURANCE CERTIFICATE (2)ACORD CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DWYYYY( 'D PRODUCER Brown & Brown Inc oPlo J SEOP ID 10 08 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION 125 S Howes, 5th Floor ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE P 0 Box 2226 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR Fort Collins CO 80522-2226 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Phone:970-482-7747 Fax:970-484-4165 I INSURED S - -"---- ----- INSURERS AFFORDING COVERAGE I NAIC # � INSURER A Mountain_ States Mutual 14648 Security Document Destruction National Recycling Inc DBA INSURERS-Plnndc0l Assurance COmpdny l Q4648 1190 --- PO Box 2472 IINSURER C I - Ft Collins CO 80522-2472 _.. _INSURER O: 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. VSR ADO _ _TR NSR TYPE OF INSURANCE POLICY NUMBE0.-POLfCY EFFE"DTIVE POLICY EXPIRATION` --__-- "---'- ------ DATE MMIDD/YYI DATE MMIDDnY LIMITS GENERAL LIABILITY A X X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 10 i CPP011394802 I 11/21/07 I 11/21/08 I pAMAGETURENMED ceZ I $ 10 CLAIMS MADE X_ j OCCUR - 'MEDEXP(Anyone person) $10 4. - I PERSONALS ADV INJURY ; $ 10 GEN'L AGGREGATE LIMIT APPLIES PER: .I aorvenq�gGGREGATE $ 3.000000 - PRO- -- LOC POLICY JECT PRODUCTS COMP/OP AGG $ O AU70MOBILE LIABILITY A I X ANY AUTO BAP011394802 11/21/07 I COMBINED SINGLE LIMIT 11/21/08EO accident) $1000000 -_1ALL OWNED AUTOS I "-�SCHEDULED AUTOS BODILY INJURY $ HIRED AUTOS (Per person) NON -OWNED AUTOS "1 BODILY INJURY $ (Pereccid I) PROPERTY DAMAGE $ (Per eccitlanI) GARAGE LIABILITY _.._ ANY AUTO AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC $ E%CESSIUMBRELLjA LIABILITY _ AUTO ONLY: AGG $ A IX -_I OCCUR CLAIMSMADE UM8011394B02 11/21/07 EACH OCCURRENCE $ 1000000 .. 11/21/08 AGGREGATE _ Doom DEDUCTIBLE _-$1O X 1 RETENTION $10000 I .. _ $ COMPENSATION AND $ B iWORKERS EMPLOYERS' LIABILITY ANYPROPRIETORIPARTNER/E%ECUTIVE 14106946 I I X I T0RV LIMITS I ER �- OFFICERIMEMBEREXCLUDED? 10/01/08 10/01/09 1[ EL EACH ACCIDENT $ lO000D0 If yECJAL PRO under I SPECIAL PROVISIONS below � I -__- _.I I EL DISEASE EA EMPLOYE $ 1000000 OTHER � _ E.L. DISEASE POLICY LIMIT i $ 1000 n nn City of Fort ONS Collins isincluded �as Additional eInsured PasSlrespects the operations of the named insured. City of Fort Collins 215 N. Mason St. Fort Collins CO 80521 CITYFIO I SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATIO 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 (2001/08) -- ©ACORD CORPORATION 1988 ACORD CERTIFICATE OF LIABILITY INSURANCE OP ID J DATE(MMIDO/YYYY) PRODUCER SECURID 10 27 00 Brown & Brown Inc THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION 125 S Howes, 5th Floor ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE P O Box 2226 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR Fort Collins CO 80522-2226 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE_ �NAIC# Phone:970-482-7747 Fax:970-484-4165 - --_-- INSURED -- __ I - I INSURER A: Mountain States Mutual � 14648 Security Document Destruction NOInc � INSURERB Pinnacol Assurance Company 41190 - -- BonDBA 72 INSURER c. - Ft Collins CO 80522-2472 ,INSURER D COVERAGES 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 POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. AND CONDITIONS OF SUCH INSR'ADD' ._— —._--- _.. .-.—.._.__ LTR WSR TYPE OF INSURANCE POLICY NUMBER ;POLICY EFFECTIVE -';POLICY EXPIRATION -- _. I GENERAL LIABILITY ' DATE MM/DDM/ DATE MM/DDIVY LIMITS ' A X COMMERCIAL GENERAL LIABILITY CPP011394802 EACH OCCURRENCE I $ 1000000 it I I JCLAIMS MADE $ j OCCUR 11/21/07 11/21/0S DAMAGE TO RENTED--'- !-PREMISES {Ea occurencJ - - - i $ 1DDDQ_D MED EXP(Any one person) 1$10000 --"_---"'------- I PERSONAL& ADV INJURY $1000000 _----""'"--- "---"'_--- GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE ---- ---- $ 1000000 I POLICY I PRO PRODUCTS COMP/OP. AGG $ 0 LOC I i AUTOMOBILE LIABILITY A IX ANVAUTO �'- BAP011394802 I 11/21/07 OM61NEDISINGLE LIMIT 11/21/08II ) $1000QQQ ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY (Per person) $ HIRED AUTOS I 1 NON -OWNED AUTOS i BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) 1 $ GARAGE LIABILITY ANYAUTO AUTO ONLY - EA ACCIDENT —__.—._ __..—__ $ OTHER THAN EA $ --- AUTO ONLY ---"- EXCESSIUMBRELLA LIABILITY AGG $ A 1 r---I _j OCCUR CLAIMS MADE UMB011394802 11/21/07 EACHOCCURRENCE 11/21/QS $ 1000000 I AGGREGATE - -1 DEDUCTIBLE I$1000000 --- $ X, RETENTION $10000 I WORKERS COMPENSATION AND EMPLOYERS' LIABILITY X �TOR_Y $ B ANY PROPRIETOR/PARTNER/EXECUTIVE 14108948 OFFICER/MEMBER EXCLUDED? LIMITS ER } 10/01/08 I 10/01/09 I EL EACH ACCIDENT _ _ $ 1000000 Ifyes, describe under SPECIAL PROVISIONS below E.L.DISEASE EA EMPLOYE E,j _ $ 1000000 OTHER --_ I ELDISEASE-POLICYLIMIT $ 10000Q0 l DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/ EXCLUSIONS ADDED BY ENDORSEMENT SPECIAL PROVISIONS CERTIFICATE HOLDER City of Fort Collins 215 N Mason Fort Collins CO 80522 FTCPURC I SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATIO 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 $0 SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR 25