HomeMy WebLinkAbout113109 WATERFORD CORPORATION - INSURANCE CERTIFICATE (6)ACORD, CERTIFICATE OF LIABILITY INSURANCE
DATE/OD
1z/23/z008os
PRODUCER (970)223-0924 FAX (970)267-2231
Colorado BW Insurance Agency, Inc.
1075 W Horsetooth Rd, Ste 106
Fort Collins, CO 80526
THIS 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 #
INSURED Waterford Corporation
404 N Link Lane
Fort Collins, CO 80524
INSURERA: Auto -Owners Insurance Group
INSURER 8:
INSURER C:
INSURER D:
INSURER E:
DINT/�:7a[N�9
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'L 31
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
07/01/2008
POLICY EXPIRATION
LIMITS
GENERAL LIABILITY
74005303
07/01/2009
EACHOCCURRENCE
$ 1,000,000
X COMMERCIAL GENERAL LIABILITY
CLAIMS MADE M OCCUR
DAMAGE TO RENTED
(Ea mr.-cance)
$PREMISES 300,000
$ 10,000
MED EXP (Any one person)
A
X
PERSONAL & ADV INJURY
$ 1,000,000
GENERAL AGGREGATE
$ 2,000,000
GENT AGGREGATE LIMIT APPLIES PER:
X POLICY PRO-
F OC
PRODUCTS - COMP/OP AGG
$ 2,000,000
AUTOMOBILE
LIABILITY
ANY AUTO
4513177806
07/01/2008
07/01/2009
COMBINED SINGLE LIMIT
(Ea accident)
$
1,000,000
X
BODILY INJURY
(Per person)
$
A
X
ALL OWNED AUTOS
SCHEDULED AUTOS
BODILY INJURY
(Per accident)
$
HIRED AUTOS
NON -OWNED AUTOS
PROPERTY DAMAGE
(Per accident)
$
GARAGE LIABILITY
AUTO ONLY - EA ACCIDENT
$
ANY AUTO
OTHER THAN EA ACC
AUTO ONLY: qGG
$
$
EXCESS/UMBRELLA LIABILITY
X OCCUR CLAIMS MADE
4513177807
07/01/2008
07/01/2009
EACH OCCURRENCE
$ 1,000,000
AGGREGATE
$ 1,000,000
A
X
$
DEDUCTIBLE
X RETENTION $ 10,00
Is
WORKERS COMPENSATION AND
WC STATU- OTH-
ER
EMPLOYERS' LIABILITY
E.L. EACH ACCIDENT I
$
ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICER/MEMBER EXCLUDED?
S yes, describe PROVISIONS
SPECIAL PROVISIONS below
E.L. DISEASE - EA EMPLOYE
$
E.L. DISEASE -POLICY LIMIT
-$
$
A
OTHER
Le
eased and Rented
Equipment
74005303
07/10/2008
07/01/2009
$100,000 with $1000 Deductible
Actual Cash Value
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS
The certificate holder is named as additional insured with respect to the ongoing operations
f the named insured. FAX: 482-0934
City of Fort Collins its officers, agents
and employees
Purchasing Department
PO Box 280
Fort Collins, CO 80524
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 MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY
OF ANY KIND U)ON THE INSURER, ITS AGENTVOA RF06SENTATIVES.
ACORD 25 (2001/081
rnRPnR4TIn NI aouR
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.
ACORD 25 (2001/08)