HomeMy WebLinkAboutGL HOFF CO - INSURANCE CERTIFICATEACORD,. CERTIFICATE OF LIABILITY
INSURANCE
D/Yvvv7
0DATE 3/30/09
PRODUCER
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Flood & Peterson Insurance Inc
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
4821 Wheaton Drive
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
INSURERA: Travelers Insurance Company
INSURERS Plnnacol Assurance
INSURER C:
.__....._..__ ............._...._—
INSURER D:
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
OATS MFFECTIY
POLICY DATE
DATE EXPIRATION
LIMITS
A
GENERAL LIABILITY
X COMMERCIAL GENERAL LIABILITY
CLAIMS MADE 51OCCUR
X PD Ded:2,500
DTC032SD6564IN
04/01/09
04/01/10
EACH OCCURRENCE
$1000000
DAMAGE TO RENTEDPREMISES (Ea occurrence)
$300OOO
MED EXP (Any one person)
$5 Q00
PERSONAL &AOV INJURY
$1000000
GENERAL AGGREGATE
s2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
POLICY-X] jECOT LOC
PRODUCTS - COMP/OP AGO
s2,000,000
A
AUTOMOBILE
LIABILITY
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON -OWNED AUTOS
810325D6564TIL
04/01/09
04/01/10
COMBINED SINGLE LIMIT
(Ea accident)
&1,000,000
X
BODILY INJURY
(Per person)
$
X
BODILY INJURY
(Per accident)
$
X
PROPERTY DAMAGE
(Per accident)
$
GARAGE LIABILITY
ANY AUTO
AUTO ONLY - EAACCIDENT
$
OTHER THAN EA ACC
AUTO ONLY: AGG
$
$
A
EXCESS/UMBRELLA
LIABILITY
OCCUR CLAIMS MADE
DEDUCTIBLE
RETENTION $ 1 O 000
DTSMCUP325D656
04/01/09
04/01/10
EACH OCCURRENCE_
$1000000
-X1
AGGREGATE
$1,_000 OOO
$
X
$
B
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY
ANY PROPRIETOR/PARINERIEXECUTIVE
OFFICER/MEMBER EXCLUDED?
It yes, describe under
SPECIAL PROVISIONS below
2242590
04/01/09
04/01/10
OTH-
X I WC SLIMIT�TATU IER
E.L. EACH ACCIDENT
$5CO OOO
E.L. DISEASE EA EMPLOYEE
$500,000
E.L. DISEASE -POLICY LIMIT
1 s500,000
OTNER
I-T
DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS
City of Fort Collins
215 N. Mason Street
Fort Collins, CO 80522
I ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
iEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 'in DAYS WRITTEN
TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
REPRESENTATIVE
ACORD 25 (2001108) 1 of 2 #M439985 CAZ 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 (2001108) 2 of 2 #M4399A5