HomeMy WebLinkAboutAMERICAN PALLET - INSURANCE CERTIFICATEACORD
PRODUCER
PINNACOL ASSURANCE
7501 E Lowry Blvd
Denver. CO 80230-7006
CERTIFICATE OF LIABILITY INSURANCE DATED M/DD0/009 YY)
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 NSURLIH- PINNACOL ASSURANCE 41190
AMERICAN PALLET AND TRUCK WASH LLC -
INSURER B
3700 Canal Dr
INSURER C
Fort Collins, CO 80524
INSURER D
INSURER E
I
COVERAGES
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDNG
ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMMENT 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. LIMITS SHOWN_ MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR ADO'L I POLICY EFFECTIVE POLICY EXPIRATION
LTR INSRD TYPE OF INSURANCE POLICY NUMBER DATE(MM/DD/YYYY) DATE(MM/DD/YYYY) LIMITS
_ GENERAL LIABILITY EACH OCCURRENCE _
COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED
CLAIMS MADE OCCUR PREMISES
MED EXP(Any one person)
PERSONAL& ADV INJURY
GEN'L AGGREGATE LIMIT APPLIERS PER GENERAL AGGREGATE
PROJECT LOG PRODUCTS - COMP/OP ASS
POLICY 1
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT
_ ANY AUTO (Ea Accident)
_ ALL OWNED AUTOS BODILY INJURY
SCHEDULED AUTOS (Per person)
HIRED AUTOS BODILY INJURY
NON -OWNED AUTOS (Per accident)
GARAGE LIABILITY
ANY AUTO
_ I EXCESSIUMBRELLA LIABILITY
OCCUR CI CLAIMS MADE
DEDUCTIBLE
RETENTION S
WORKERS COMPENSATION AND
EMPLOYER'S LIABILITY
ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICER/MEMBER EXCLUDED'
If yes, pleasodescnbeondei SPECIAL PROVISIONS bolo.
OTHER
PROPERTY DAMAGE
(Pei accident)
AUTO ONLY - EA ACCIDENT
OTHER THAN EA T;CAUTO ONLY A
EACH OCCURRENCE
AGGREGATE -
XI WC STATU- OTHER
4114186 06/01/2009 06/01/2010 TORY.LIMITS
E. L EACH ACCIDENT $100,000
E.L DISEASE - EA EMPLOYEE $1001000
E.L DISEASE- POLICY LIMIT _ $500 0 0 _ _ _-
DESCRIPTION OF OPERATIONS/LOCATIONSIVEHICLES/EXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS
CERTIFICATE HOLDER
1170091
City of Fort Collins
Atten: John Stephens
215 North Mason Street
Fort Collins CO 80521
CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY 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 COMPANY, ITS AGENTS OR
REPRESENTATIVES.
AUTHORIZED REPRESENTATIVE
Aundria Martin
ACORD 25(2001/08) Underwriter ACORD CORPORATION 1988