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HomeMy WebLinkAboutSECURITY DOCUMENT DESTRUCTION - INSURANCE CERTIFICATE (3)ACORo,. CERTIFICATE OF LIABILITY INSURANCE PRODUCER Brown & Brown Inc 125 S Howes, Sth Floor P 0 Box 2226 Fort Collins CO 80522-2226 Phone:970-482-7747 Fax:970-484-4165 Security Document Destruction National Recycling Inc DBA PO Box 2472 Ft Collins CO 80522-2472 nnvconncc DATE (MM/DD/YYYY) 11/20/08 I HIS 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 BELOW. INSURERS AFFORDING COVERAGE NAIC # INSURER A: Mountain States Mutual 14648 INSURER Pinnacol Assurance company 41190 INSURER C INSURER D: 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 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 DD' __-_._._____—_____ .. _ _.________...._. __ _ POLIC LTR NSR TYPE OF INSURANCE POLICY NUMBER DATE EFFECTIVE PDATE JMMIODNY) LIMITS DATE MM/ODIYY DATE MMIDD/YV LIMITS GENERAL LIABILITY _. EACH OCCURRENCE $ 11000, 000 A X X COMMERCIAL GENERAL LIABILITY CPP 011394803 11/21/08 11/21/09 AMAGETORENTFD PREMISES (Ea occurence) $ 100, 000 CLAIMS MADE [X7 OCCUR _ _" ______ —__. _ MED EXP(Any one person) $10 000 PERSONAL &ADV INJU RY $ 1,000,000 GENERAL AGGREGATE $ 11000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGO $excluded POLICY JECT LOG ---� _ -- AUTOMOBILE LIABILITY A X- ANY AUTO BAP011394803 11/21/08 11/21/09 COMBINEDSINGLE LIMIT (Eaaccldenp $ 11000,000 ALL OWNED AUTOS - --'"" _. SCHEDULED AUl05 BOUILY INJURY (Per person) $ HIRED AUTOS _"'""'" BODILY INJURY $ NON -OWNED AUTOS (Per accident) .__—__.__... PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY . AUTO ONLY - EA ACCIDENT $ ANY AUTO -- OTHERTHAN EAACC $ AUTO ONLY: AGG $ EXCESS/UMBRELLA LIABILITY __ EACH OCCURRENCE $1,000,000 A X OCCUR .l CLAIMS MADE UMB011394803 11/21/08 11/21/09 AGGREGATE $ 11000,000 DEDUCTIBLE- - $ X RETENTION $10,000 - $ WORKERS COMPENSATION AND EMPLOYERS' X TORY LIMNS F.R B LIABILITY _ ANY PROPRIETORIPARTNERIEXECU'IIVE 4108948 10/01/08 10/01/09 EL EACH ACCIDEM $ 11000,000 OFFICER/MEMBERsenbc,noEXCLUDED? I( yes, tlescribe under EL DISEASE -EA EMPLOYEE $ 1 000, 000 _ SPECIAL PROVISIONS below _ _ _ E.L.DISEASE- POLICY LIMIT 1,000, 000 OTHER DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES /EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS City of Fort Collins is included as Additional Insured as respects the operations of the named insured. CITYFI0 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN City of Fort Collins NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL 215 N. Mason St. IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR Fort Collins CO 80521 REPRESENTATIVES. HOR ED REPRESENTATI �l S. C'lL✓C _ ACORD 25 (2001108) © ACORD CORPORATION ACOR4,. CERTIFICATE OF LIABILITY INSURANCE OF ID P6 DATE IMM/DDIVYYV) SECURID I 11 20 08 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Brown & Brown Inc ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 125 S Howes, 5th Floor HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR P O Box 2226 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Fort Collins CO 80522-2226 Phone:970-482-7747 Fax:970-484-4165 INSURERS AFFORDING COVERAGE NAIL# INSURED INSURERA. Mountain States Mutual _ 14648 _ INSURERR Pinnacol Assurance 0 Company 4119 Security Document Destruction -- "-- '""'- --"--- --' - 9 --- National Recycling Inc DBA INSURER ___ _... ._— __ __._ ._...._. PO BOX 72 Ft Collins CO 80522-2472 - INSURER I HE 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 OP SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, INSRI DD'---___—'" _ __"- _- -- "—__-"— __— POLICY EFFECTIVE -POLICY EXPIRATION _--- "- LTR NSR TYPE OF INSURANCE POLICY NUMBER DATE MM/DDIYY DATE EXPIRATION LIMITS GENERAL LIABILITY EACH OCCURRENCE $1,000,000 A X COMMERCIAL GENERAL LIABILITYDAMAGE CPP011394803 11/21/0$ 11/21/09 0 RENTED PREMISES_ Eaoccurence) $ 100, 000 CLAIMS MADE �.X, OCCUR MED EXP(Any one person) $10,000 PERSONAL B ADV INJURY $1,000, 000 GENERAL AGGREGATE $ 1, 000, 000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OPAGG $excluded POLICY PRO- JECT LOG --- ---- -- - AUTOMOBILE LIABILITY A X ANY AUTO BAP011394803 11/21/08 11/21/09 COMBINED SINGLE LIMIT (Ea accident) $11000,000 ALL OWNED AUTOS - _- �------.- BODILY INJURY S SCHEDULED AUTOS (Per person) HIRED AUTOS BODILY INJURY $ NON -OWNED AUTOS (Per accident) PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ ANY AUTO -- QTHER 'THAN EA ACC .. $ AUTO ONLY: AGO $ EXCESS/UMBRELLA LIABILITY --I EACH OCCURRENCE $ 1, 000,000 A X,. OCCUR F. CLAIMSMADE UMB011394803 11/21/08 11/21/09 AGGREGATE $ 1,000,000 ..... DEDUCTIBLE X RETENTION $10, oQQ Is WORKERS COMPENSATION AND X TORY LIMITSWC STATU- LR B EMPLOYERS' LIABILITY - ANY PROPRIETOR/PARTNER/EXECUTIVE 4108948 10/01/08 10/01/09 EL EACH ACCIDENT $1,000,000 OPPICERIMF:MRF.REXCLUDED? 11 yes, describe under E.L. DISEASE EAEMPLOYEE $1 000,000.. SPECIAL PROVISIONS below E. L. DISEASE -POLICY LIMIT $1,000,000 OTHER DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS FTCPURC SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN City of Fort Collins NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL 215 N Mason IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR Fort Collins CO 80522 REPRESENTATIVES. HOR ED REPRESENTOTT ACORD 25 (2001/08) C) ACORn CORPORATION 9QRR