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HomeMy WebLinkAbout119633 MASEK GOLF CAR COMPANY - INSURANCE CERTIFICATE (2)ACORD CERTIFICATE OF NL LIABILITY INSURANCE OP ID NL DATE (MM/DD/YYYY) 11P,ID 02 03 09 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Richard Maxedon ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE C.J. Thomas Company, Inc. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 800 Market Street, 18th Floor ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. St. Louis MO 63101 Phone : 314-231-1717 Fax•: 314-231-4482 - INSURERS AFFORDING COVERAGE- NAIC # INSURED INSURER A: National Fire. -..-.:- 20478 INSURERB: Continental' InsuraIlc2: -• -35289_.._ .._Masek, Distributing., ..Inc..... -} 'Fund New Ports LLC INSURER Accident Insurance'Co., o. -. 10166 A25 M--St building 11 - _Gering NE 69341 INSURER D: Continental Casualty Company . 20443 INSURER E: - - - - - -- ----- COVERAGES 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. LTR NSR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE MM/DD/YY POLICY EXPIRATION DATE MMIDDIYV LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A X X COMMERCIAL GENERAL LIABILITY CNP4012387759 11/09/08 11/09/09 PREMISES(Eaoccurence) $ 300,000 CLAIMS MADE FX_1 OCCUR MED EXP (Any one person) $ 10,000 PERSONAL & ADV INJURY $1,000,000 GENERAL AGGREGATE s2,000,000 GENT AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG s2,000,000 X I POLICY PRO JECT LOC B X AUTOMOBILE LIABILITY ANY AUTO BUA4012387731 11/09/08 11/09/09 COMBINED SINGLE LIMIT (Ea accident) $ 1 000 O0O � � X BODILY INJURY (Per person) $ ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY (Per accident) . $ - HIRED AUTOS - NON -OWNED AUTOS - - - PROPERTY DAMAGE (Per accident) - $ I -- - -- - - "• -- "- - GARAGE LIABILITY AUTO ONLY - EA -ACCIDENT `$ OTHER THA EA ACC $ ANY AUTO $ _.. AUTO ONLY: _ AGG EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ 1,000,000 D X OCCUR ElCLAIMSMADE CUP4012387762 11/09/08 11/09/09 AGGREGATE $1,000,000 $ DEDUCTIBLE $ X RETENTION $ 10000 C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? If yes, describe under SPECIAL PROVISIONS below WCV6050318-0 11/09/08 11/09/09 X TORY LIMITS ER E.L. EACH ACCIDENT $500, 000 E.L. DISEASE - EA EMPLOYEE s500,000 - E.L. DISEASE - POLICY LIMIT -- $ 500 , OOO OTHER D Equipment Floater IM4012163258 11/09/08 11/09/09 Golf Cars $2,167,000 Ded. $2,500 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS City of Ft. Collins, its officers, agents and employees are included as additional insured in regards to the auto liability and general liability in regards to the contract with the named insured. CERTIFICATE HOLDER CANCELLATION City of Ft Collins Attn: Jim Hume P.O. Box 580 215 N. Mason St 2nd Floor Ft. Collins CO 80522-0580 CITYOFF 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 DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. 9 ACORD 25 (2001/08) © ACORD CORPORATION 1988