HomeMy WebLinkAboutWALKER MANUFACTURING - INSURANCE CERTIFICATE (2)ACORU, CERTIFICATE OF LIABILITY
INSURANCE
IMMIDDI
1DATE
010112009YYY)
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 0 Box 270370
Fort Collins, CO 80527
INSURERS AFFORDING COVERAGE
NAIC #
INSURED
Walker Manufacturing Co.
5925 East Harmony Road
Fort Collins, CO 80528 -
INSURER A: The Hartford Insurance
INSURERS: Pinnacol Assurance
INSURER C:
- "-"—
INSURER D:
INSURER E'
COVFRAGFS
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.
ILTR
NSR
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
DATE MFFECTIY
POLICY EXPIRATION
DATE EXPIRATION
LIMITS
A
GENERAL LIABILITY
34ECSOF1729
09/30/09
09/30/10
EACH OCCURRENCE
$1 000000
X COMMERCIAL GENERAL LIABILITY
DAMAGE TO RENTED
$300000
CLAIMS MADE 51OCCUR
MED EXP (Any one person)
$
PERSONAL & ADV INJURY
$1 000 000
GENERAL AGGREGATE
s2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
PRODUCTS - COMP/OP AGG
$2000000
POLICY PRO-
JECT LOG
A
AUTOMOBILE
LIABILITY
ANY AUTO
34UUNNJO856
09/30/09
09/30/10
COMBINED SINGLE LIMIT
(Ea accident)
$1,000,000
X
BODILY INJURY
(Per person)
ALL OWNED AUTOS
SCHEDULED AUTOS
X
BODILY INJURY
(Peraccident)
$
HIRED AUTOS
NON -OWNED AUTOS
X
PROPERTY DAMAGE
(Per accident)
$
GARAGE LIABILITY
AUTO ONLY - EA ACCIDENT
$
OTHER THAN EA ACC
$
ANY AUTO
$
AUTO ONLY: AGO
EXCESSIUMBRELLA LIABILITY
EACH OCCURRENCE
$
OCCUR F-ICLAIMS MADE
AGGREGATE
$
S
$
DEDUCTIBLE
$
RETENTION
B
_$
WORKERS COMPENSATION AND �2270632
04/01/09
04/01/10
F1-
X WCSTATU- OTST
MIT E
EMPLOYERS'LIABILITY
ANY PROPRIETORIPARTNERJEXECUTIVE
E.L. EACH ACCIDENT
$SOOOOO
E. L. DISEASE - EA EMPLOYEE
$500,000
OFFICERIMEMBER EXCLUDED?
If yes, describe oner
SPECIAL PROVISIONS below
E.L. DISEASE -POLICY LIMIT
s5000OO
OTHER
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS
Certificate Holder is Additional Insured as their interests may appear
regarding land leased at:
Loc# 2 - 5244 Cessna Drive; Loveland, CO
City Manager - City of Ft.
Collins
300 LaPorte Avenue
Fort Collins, CO 80521
I ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
IEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL �30_ 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
AUTHORIZED REPRESENTATIVE y y
Y'" ini XJ✓.i � J .Q.Arf.Y i j {ifr�.,t nf. Puf;f A✓i' NI.,RJ1...{L i ,l.J\A{;',
ACORD 25 (2001108) 1 of 2 #S484102/M484097 SLS 0 ACORD CORPORATION 1988
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 (2001/08) 2 of 2 #S484102/M484097