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HomeMy WebLinkAboutAMI FIREPLACE COMPANY INC - INSURANCE CERTIFICATEOP ID 65 ACORD CERTIFICATE OF LIABILITY INSURANCE BP.ID 65 DATE (MMIDDIYYYY) 03 25 09 PRODUCER Cottingham & Butler, Inc. 800 Main Street Dubuque IA 52001 Phone: 563-587-5000 Fax:563-583-7339 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 AMI Fireplace Company Inc PO BOX 9229 Green Bay WI 54308 INSURER A: Hartford Insurance 29424 INSURERB: American Guarantee & Liability 26247 INSURERC: Hartford Fire Insurance Co 19682 INSURERD: INSURER E: CnVFRAGFS 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 INSR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE MMIDDIYY POLICY EXPIRATION DATE MM/DD/YY LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS MADE X❑ OCCUR 83UENOB8025 04/01/09 04/01/10 EACH OCCURRENCE $ 1000000 PREMISES(Eaoccurenca) $ 300000 MED EXP (Any one persony $ 10000 PERSONAL & ADV INJURY $ 1000000 GENERAL AGGREGATE $ 2000000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO JECT X LOC PRODUCTS - COMP/OPAGG $ 2000000 Deductibl 0 A AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS 83UENOBB026-OTHER STATES 83MCPOB8005-MASSACHUSETTS 04/01/09 04/01/10 COMBINED SINGLE LIMIT (Ea accident) $ 1000000 X BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY ANY AUTO AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC AUTO ONLY: AGG $ $ B EXCESS/UMBRELLA LIABILITY X I OCCUR CLAIMSMADE DEDUCTIBLE RETENTION $ AUC913715303 04/01/09 04/01/10 EACH OCCURRENCE $ 2000000 AGGREGATE $2000000 $ $ A WORKERS COMPENSATION AND EMPLOYERSLIABILITY - ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBEREXCLUDED? If yyes, describe under SPEC,ALPROVISIONS below 83WEOB8052 04/01/09 04/01/10 X TORY LIMITS ER E.L. EACH ACCIDENT _ $-1000000 E.L. DISEASE - EA EMPLOYEE $ 1000000 E.L. DISEASE -POLICY LIMIT $ 1000000 C OTHER Property 83UUMAJ7334 04/01/09 04/01/10 10000 Deductible DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT/ SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION CITOCOL 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 DO SO SHALL City of Fort Collins P.O. Box 580 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR Collins CO 80522 REPRESENTATIVES. A OR REPRES NTATIV ACORD 25 (2001/08) © 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 (2001/08)