HomeMy WebLinkAbout108976 L AND M ENTERPRISES INC - INSURANCE CERTIFICATEACORD CERTIFICATE OF LIABILITY INSURANCE
DATE
10/15/2009)
PRODUCER (970)679-7333 FAX (866)456-4265
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Ewing -Leavitt Insurance Agency
4025 St . Cloud Dr.
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Suite .100
Loveland; C0:.80538-..__.. .__._._renee-stein@leavitt.•com
INSURERS AFFORDING COVERAGE.._ -- -
-NAIC#
INSURED L.&-M .Enterpri.ses, _.Inc.
INSURERA: Secura Insurance; Company-
I P._0 BOX W
INSURERB: Sequoia Insurance -Company- -
22985-
Berth6ud; ``CO' 80513
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.
INSR
ADD -
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
POLICY EXPIRATION
LIMITS
GENERAL LIABILITY
CP3155200
10/01/2009
01/01/2010
EACH OCCURRENCE
$ 1,000,000
- X COMMERCIAL GENERAL LIABILITY
DAMPP,AGE TO RENTED
$ 100,000
CLAIMS MADE U OCCUR
MED EXP (Any one person)
$ S,000
A
X Bl kt Addl Insureds
PERSONAL & ADV INJURY
$ 1,000,000
X
Bl kt Wvr Su rogtn
GENERAL AGGREGATE
$ 2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
PRODUCTS - COMP/OP AGG
$ 2,000,000
POLICY X PRO
JECT LOC
_AUTOMOBILE
LIABILITY
ANY AUTO
A3155201
10/01/2009
01/01/2010
COMBINED SINGLE LIMIT
(Ea accident)
$
1,000,000
X
BODILY INJURY
(Per person)
$ .. _
-
A
ALL OWNED AUTOS
S
SCHEDULED AUTOS
HIRED AUTOS
NON -OWNED AUTOS
-
"
_
_.. -_
X
BODILY INJURY
(Per accident)
$
X
PROPERTY DAMAGE
(Per acci e �d rit)"_
$
GARAGE LIABILITY
AUTO ONLY - EA ACCIDENT
$
OTHER THAN EA ACC-
$
ANY AUTO
- _
$
AUTO ONLY: AGG
EXCESS/UMBRELLA LIABILITY
CU315 5202
10/01/2009
01/01/2010
EACH OCCURRENCE
$ 8,000,000
X OCCUR ❑ CLAIMS MADE
AGGREGATE
$ 8,000,000
A
$ 0
$
DEDUCTIBLE
X RETENTION $ 10 , 00
$
WORKERS COMPENSATION AND
SWP203829-1
01/01/2009
01/01/2010
X WC srnru- oTH-
FR
ER
B
EMPLOYERS' LIABILITY
ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICER/MEMBER EXCLUDED?
E.L. EACH ACCIDENT
$ 1,000,000
—__
E.L. DISEASE - EA EMPLOYEE
_.._
$ ]L,000,000
If yes, describe under
SPECIAL PROVISIONS below
E.L. DISEASE - POLICY LIMIT
$ 1,000,000
A
OTHER
Contra tors' Equipment
CP3155200
10/01/2009
01/01/2010
Leased/Rented Equipment
$150,000 limit-$1,000 deduct
$85,000 Installation Fltr
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS
e: 7005 East Prospect Road Landscaping Improvements - City of Fort Collins, Engineer,
heir respective officers and employees are named additional insured as respects work performed.
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL
City of Fort Collins ..Financial Services 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,
Purchasing Division BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY
215 N . Mason St. 2nd Floor OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES.
Fort Collins, CO 80522 AUTHORIZED REPRESENTATIVE I
Renee Stein/RESTEI e
ACORD 25 (2001/08) @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 (2001108)