HomeMy WebLinkAbout105719 LONCO INC - INSURANCE CERTIFICATE (3)ACORD. CERTIFICATE OF LIABILITY INSURANCE 0DATE
4/02/09D/Yv)
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Van Gilder Insurance Corp. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
700 Broadway, 1000 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
y ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Denver, CO 80203
303 837-8500 INSURERS AFFORDING COVERAGE
INSURED _ INSURER A: Hartford Fire Insurance Company
Lonco, Inc. INSURER B: Hartford Underwriters Insurance Co
1700 Broadway, #1512 INSURER c: Hartford Ins Co of the MidWest
Denver, CO 80290 INSURER D: XL Specialty Insurance Company
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.
INSR
LTR
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
DATE MWDD/YY
POLICY EXPIRATION
DATE MM/DD/YY
LIMITS
A
GENERAL LIABILITY
34SBAEK7231
04/01/09
04/01/10
EACH OCCURRENCE
$2 000 000
FIRE DAMAGE (Any one fire)
$300 000
X COMMERCIAL GENERAL LIABILITY
CLAIMS MADE Fx_1 OCCUR
MED EXP (Any one person)
$5 000
PERSONAL & ADV INJURY
$2 000 000
GENERAL AGGREGATE
s4,000,000
GEN'L AGGREGATE LIM ITAPPLIES PER:
PRODUCTS - COMP/OP AGG
s4,000,000
POLICY PRO LOC
JECT
B
AUTOMOBILE
LIABILITY
ANY AUTO
34UECEX5813
04/01/09
04/01/10
COMBINED SINGLE LIMIT
(Ea accident)
$1,000,000
X
BODILY INJURY
(Per person)
$
ALL OWNED AUTOS
SCHEDULED AUTOS
X
BODILY INJURY
(Per accident)
$
HIRED AUTOS
NON -OWNED AUTOS
X
PROPERTY DAMAGE
(Per accident)
$
GARAGE LIABILITY
AUTO ONLY - EA ACCIDENT
$
OTHER THAN EA ACC
$
ANY AUTO
$
AUTO ONLY: AGG
A
EXCESS LIABILITY
34SBAEK7231
04/01/09
04/01/10
EACH OCCURRENCE
s2,000,000
X OCCUR CLAIMS MADE
AGGREGATE
s2,000,000
$
$
DEDUCTIBLE
RX
$
RETENTION $1 U 000
C
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY
34WEGKC1058
04/01/09
04/01/10
X WC STATLIIT O
TY R
E.L. EACH ACCIDENT
$1,000,000
E.L. DISEASE - EA EMPLOYEE
$1,000,000
E.L. DISEASE - POLICY LIMIT
$1,000,000
D
OTHER Professional
DPR9615730
04/01/09
04/01/10
$1,000,000 per claim
Liability
$1,000,000 annl aggr.
Claims Made
DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
RE: City of Fort Collins' Bridge inspecting, maintenance and repair program.
The Certificate Holder its officers and employees are included as Additional Insureds
under General Liability as required by written contract.
*Except 10 days notice for non-payment of premium.
lya:111ll2Nl_\I;0iPJRIJaa
City Of Fort Collins
Purchasing Division
Opal Dick, CPPO, Senior Buyer
P. O. Box 580
Fort Collins, CO
SHOULD ANYOFTHE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TOMAIL30* DAYSWRITTEN
NOTICETOTHE CERTIFICATE HOLDERNAMED TOTHE LEFT, BUTFAILURE TODOSOSHALL
IMPOSE NO OBLIGATION OR LIABILITYOF ANYKIND UPON THE INSURER,ITS AGENTS OR
REPRESENTATIVES.
A HORIZED REPRESENTATIV
,A_..a.., C .
ACORD 25-S (7/97)1 Of 2 #S563752/M563749 KAB 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.
ACORD25-S(7/97)2 of 2 #S563752/M563749