HomeMy WebLinkAbout455175 NATIONAL CENTER FOR CRAFTMANSHIP - INSURANCE CERTIFICATEA—C-0—=Dn CERTIFICATE OF LIABILITY INSURANCE
DATE /2009 (M1
04/2/2009
PRODUCER (970)679-7333 FAX (866)456-4265
Ewing -Leavitt Insurance Agency
4025 St. Cloud Dr.
Suite 100
Loveland, CO 80538
THIS CERTIFICATE IS ISSUED AS AMATTER 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 National Center for Craftmanship
c/o Neil Kaufman
5680 N. Hwy 1
Fort Collins, CO 80524
INSURER&. Penn Star Insurance Company
10673
INSURERS: Pinuacol Assurance
41190
INSURER C:
INSURER D:
INSURER E:
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,
NSR
IIm
D'
NMI
TYPE OF INSURANCE
POLICY NUMBER
POLICYEFFECTIVE
(MMIDnNY)
POLICYEXPRATIONDATE
DATE IMMIDTIYYj
LIMITS
A
GENERAL LIABILITY
X COMMERCIAL GENERAL LIABILITY
CLAIMS MADE OCCUR
PAC6816847
02/05/2009
02/05/2010
EACHOCCURRENCE
$ 11000,000
DAMAGE TORENTED
§ 100,000
$ 1,00
MED EXP(my one person)
PERSONAL & ADV INJURY
$ 1,000,00C
GENERAL AGGREGATE
$ 21000100
GEN'L AGGREGATE LIMIT APPLIES PER:
X POLICY PRO-
ECT OC
PRODUCTS-COMP/OPAGG
$ INCLUDED
AUTOMOBILE
LIABILITY
ANYAUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIREDAUTOS
NON OWNED AUTOS
COMBINED SINGLE LIMIT
(Ea accident)
$
Der person)
S
BODILY INJURY
(Per accident)
§
PROPERTY DAMAGE
(Per accident)
§
GARAGE LIABILITY
ANYAUTO
AUTO ONLY - EA ACCIDENT
$
O�ER THAN EA ACC
AUTO ONLY: qGG
§
$
EXCESS/UMBRELLAUABILITY
OCCUR CIAIMS MADE
DEDUCTIBLE
RETENTION §
EACH OCCURRENCE
S
AGGREGATE
§
5
$
B
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY
ANY PROPRIETOR/PARTNERIEXECUTIVE
OFFICEFUMEMBER EXCLUDED?
If yes, describe under
SPECIAL PROVISIONS below
OTHER
412$791
01/15/2009
Ol/O1/2010
X WC STATU- DTH-
E.L. EACH ACCIDENT
$ 100,000
E.L. DISEASE, EA EMPLOYEE
$ 100,000
E.L. DISEASE -POLICY LIMIT $ 500,000
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS
ity of Fort Collins, its officers, agents and employees are listed as an additional insured
s respects work performed.
e: Deconstruction for PFA Station 4
City of Fort Collins
Purchasing Dept
John D. Stephen, Senior Buyer
P 0 Box 280
Fort Collins, CO 80522
ACORD25=01/081 FAX: (970)221-
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF, THE ISSUING INSURER 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 INSURER, ITS AGENTS OR REPRESENTATIVES,
AUTHORIZED REPRESENTATIVE
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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 after the coverage afforded by the policies listed thereon.
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