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HomeMy WebLinkAboutGL HOFF - INSURANCE CERTIFICATE (4)ACORD, CERTIFICATE OF LIABILITY INSURANCE 0DATE (MM/D 3/30/09DNYYY) PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Flood & Peterson Insurance Inc 4821 Wheaton Drive ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. P O Box 270370 Fort Collins, CO 80527 INSURERS AFFORDING COVERAGE NAIC # INSURED;_ _ - G.L. Hoff Co.. 1815-W..12th Street; P.O. Box 7448 (Loveland, CO 80537 INSURER A: Travelers Insurance Company - - INSURER B:. Pinnacol Assurance INSURERC: INSURER D: INSURER E: COVFRAnFR 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 MMIDD/YY LIMITS A GENERAL LIABILITY DTC0325D65641N 04/01/09 04/01/10 EACH OCCURRENCE $1 000 000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RPREMISES tE.ENTED $300OOO CLAIMS MADE 51OCCUR MED EXP (Any one person) $5 000 PERSONAL & ADV INJURY $1 000 000 X PD Ded:2,500 GENERAL AGGREGATE s2,000,000 GEML AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG s2,000,000 POLICY X PRO LOC JECT A AUTOMOBILE LIABILITY X ANY AUTO 810325D6564TIL 04/01/09 04/01/10 COMBINED SINGLE LIMIT (Ea accident) $1 ,OOO ,000 BODILY INJURY (Per person) $ ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY (Per accident) $ X HIRED AUTOS X NON -OWNED AUTOS PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC $ ANY AUTO $ AUTO ONLY: AGG A EXCESS/UMBRELLA LIABILITY DTSMCUP325D656 04/01/09 04/01/10 EACH OCCURRENCE $1 000 000 X OCCUR CLAIMS MADE AGGREGATE $1 OOO OOO $ DEDUCTIBLE - $ X RETENTION $ 10 000 B WORKERS COMPENSATION AND 2242590 04/01/09 04/01/10 TH- X WRY C LIMITTATUFIR EMPLOYERS' LIABILITY ANY FROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $500 000 E.L. DISEASE - EA EMPLOYEE s500,000 OFFICER/MEMBER EXCLUDED? If yes, describe under SPECIAL PROVISIONS below E.L. DISEASE - POLICY LIMIT $500,000 OTHER DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS Certificate holder is named as additional insured as their interest may appear in regards to the operations of the named insured. (Excluding Workers' Compensation) Bond Renewal 11ULUtK City of Fort Collins Bond Renewal P.O. Box 580 Fort Collins, CO 80522 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 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVE ACORD 25 (2001/08) 1 of 2 #M439985 CAZ © 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 #M439985