HomeMy WebLinkAboutTHE PREMIER COMPANY LLC - INSURANCE CERTIFICATE (3)PREC04
ACORDTM CERTIFICATE OF LIABILITY INSURANCE
I UATE(MM/D gYYY)
PRODUCER
THIS CERTIFICATE IS ISSUED AS A -MATTER OF INFORMATION • -
Flood &Peterson •Insurance Inc
4821 Wheaton Drive
r.-'_i
P O Box •27,0370 E
Fort Collins, CO 80527
b
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 j-.• •„r r ,•, 'y
The Premier Company,-LLC_ _.._.- _..- .. __...
113 S College #113'
Fort Collins, CO 80524
INSURERA: Plnnacol Assurance
INSURER B:
_ .. _ •.
INSURER C:
INSURER D:
INSURER E
r0VFRAC;FS
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.
n
LTR
-
NSR
TYPE OF INSURANCE
POLICY NUMBER-
IVE
POLICY EFFECTIYY
DATE M M I D D
POLICY EXPIRATION
/Y
DATE MM/DDY
LIMITS
GENERAL LIABILITY
COMMERCIAL GENERAL LIABILITY
CLAIMS MADE 1-1 OCCUR
-
" '
EACH OCCURRENCE
$
DAMAGE TO RENTED
PREMISES Ea occurrence
$
MED EXP (Any one person)
$
PERSONAL & ADV INJURY
$
GENERAL AGGREGATE
$
GEN'L AGGREGATE LIMIT APPLIES PER:
POEICY _... PRO--
JECT LOC
PRODUCTS -COMP/OP AGG
$ --'
;e
_
_
•
AUTOMOBILE
LIABILITY'
AUTO - _._--- _-_-._._..__
ALL OWNED AUTOS
i ...
SCHEDULED AUTOS
HIRED AUTOS .. .
NON -OWNED AUTOS -
�_.___ __ _ ___._.__•_.--- -, _.._
_ __ -__
`'.':i;..
_ -
-
9
)'-. .-
_ _. _.. - ._-- -_., _-
- : "-:: ':
-. '-_ •�.. --'-- --
•
- -
COMBINED SINGLE LIMIT
(Ea accident).
-.- _
_ANY
BODILY INJURY
.(Per person) . - - -_ --..
BODILY INJURY
'(Per -accident) ' ..
$ -
PROPERTY DAMAGE
(Per accident)
$
-
GARAGE LIABILITY-
ANY AUTO
E
- "
AUTO ONLY - EA ACCIDENT
$
OTHER THAN EA ACC
AUTO ONLY: AGG
$
$
EXCESS/UMBRELLA LIABILITY
OCCUR CLAIMS MADE
DEDUCTIBLE
RETENTION $I
EACH OCCURRENCE
$
AGGREGATE
$
$
A
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY
ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICER/MEMBER EXCLUDED?
If yes, describe under
SPECIAL PROVISIONS below
4089533
02/01/09
02/01/10
WC
T RY I -
X OR STATUER
E.L. EACH ACCIDENT
$100,000
E.L. DISEASE - EA EMPLOYEE
$100,000
E.L. DISEASE -POLICY LIMIT
s500,000
OTHER
DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS
L"=IZI112LOY 117i19P19gD
City of Ft Collins
200 Mountain Avenue
Fort Collins, CO 80521
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 1 f)— 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.
AUTHORIZED REPRESENTATIVE
'i4C:ORD 25 (2001/08) 1 of 2 #S435432/M435430 TLA 0 ACORD CORPORATION 1988
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-S (2001/08) 2 of 2 #S435432/M435430