HomeMy WebLinkAboutAMERICAN PALLET AND TRUCK WASH - INSURANCE CERTIFICATE (2)ACORD" CERTIFICATE OF LIABILITY INSURANCE
DATE(MM9/2009YY,
02/19/2009
PRODUCERPIN
7501 E Lowry Blvd OL ASSURANCE
501
Denver, CO 80230-7006
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
INSURERA PINNACOL ASSURANCE
41190
AMERICAN PALLET AND TRUCK WASH LLC
3700 Canal Dr
INSURER B:
_
INSURER C
Fort Collins, CO 80524
INSURER D:
INSURER E:
COVERAGES
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDNG
ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMMENT 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. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR
ADD 1
POLICY EFFECTIVE
POLICY EXPIRATION
LTR
INSRD
TYPE OF INSURANCE
POLICY NUMBER
DATE(MM/DD/YYYY)
DATE(MM/DDIYYYY)
LIMITS
GENERAL LIABILITY
EACH OCCURRENCE
DAMAGE TO RENTED
COMMERCIAL GENERAL LIABILITY
CLAIMS MADE OCCUR
PREMISES
i
MED EXP(Any one person)
PERSONAL& ADV INJURY
GEN'L AGGREGATE LIMIT APPLIERS PER:
GENERAL AGGREGATE
PRODUCTS - COMP/OP AGG
POLICY PROJECT LOC
AUTOMOBILE LIABILITY
COMBINED SINGLE LIMIT
ANY AUTO
(Ea Accident)
BODILY INJURY
ALL OWNED AUTOS
SCHEDULED AUTOS
(Per person)
BODILY INJURY
HIRED AUTOS
NON -OWNED AUTOS
(Per accident)
PROPERTY DAMAGE
(Per accident)
GARAGE LIABILITY
AUTO ONLY - EA ACCIDENT
OTHER THAN EA ACC
ANY AUTO
AUTO ONLY: AG
EXCESS/UMBRELLA LIABILITY
EACH OCCURRENCE
AGGREGATE
OCCUR E1 CLAIMS MADE
DEDUCTIBLE
RETENTION $
WORKERS COMPENSATION AND
WC STATU- OTHER
A
EMPLOYER'S LIABILITY
ANY PROPRIETOR/PARTNER/EXECUTIVE
4114186
06101/2008
06/0112009
TORY LIMITS
EEACH EACH ACCIDENT
$100,000
OFFICERIMEMBER EXCLUDED?
El DISEASE - EA EMPLOYEE
$100,000
If yes, please describe under SPECIAL PROVISIONS below
El DISEASE -POLICY LIMIT
$500,000
OTHER
DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLESIEXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
CERTIFICATE HOLDER
CANCELLATION
1134980
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
City of Fort Collins
Atten: John Stephens
215 North Mason Street
Fort Collins CO 80521
THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO
MAIL 30 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 UPON THE COMPANY, ITS AGENTS OR
REPRESENTATIVES.
AUTHORIZED REPRESENTATIVE
Aundria Martin
ACORD 25(2001108)
Underwriter ACORD CORPORATION 1988