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HomeMy WebLinkAbout103009 PORTER INDUSTRIES INC - INSURANCE CERTIFICATE (21)Client#: 14405 PORIN ACORD. CERTIFICATE OF LIABILITY INSURANCE DATE 12/30/2009 ' PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Flood & Peterson Insurance Inc .4821 Wheaton Drive ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.. P O Box 270370,.. Fort Collins, CO 80527 INSURERS AFFORDING COVERAGE , - NAIC # . INSURED INSURERA Travelers Insurance Company - Porter Industries, Inc. INSURER B: Pinnacol Assurance 5202 Granite Street Loveland, CO 80538 INSURERC: 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 LTR ADD1 INSRE PE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE MM DD POLICY EXPIRATION DATE M DD LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS MADE Fx� OCCUR Y630352OP334TILl 01/01/10 01/01/11 EACH OCCURRENCE $1 000 000 DAMAGE TO RENTED orpurrmcAl $300 000 MED EXP (Any one person) $10 000 PERSONAL & ADV INJURY $1 000 000 GENERAL AGGREGATE s2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: X POLICY PROECT LOC J PRODUCTS - COMP/OP AGG s2,000,000 A AUTOMOBILE LIABILITY ANY,AUTO _ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS Y810352OP334TILl 01/01/10 - 01/01/11 COMBINED SINGLE LIMIT (Ea accident) $1,000,000 - X BODILY INJURY (Per person) $ _ X BODILY INJURY (Per accident) $ X PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY ANY AUTO AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC AUTO ONLY: AGG $ $ A EXCESSIUMBRELLA LIABILITY X OCCUR CLAIMS MADE DEDUCTIBLE X RETENTION $ 10000 YSMCUP352OP334TI 01/01/10 01/01/11 EACH OCCURRENCE $1 000 000 AGGREGATE $1 00O 000 $ $ "B 'WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICERIMEMBER EXCLUDED? If yes, describe under SPECIAL PROVISIONS below 4U3Sc"5s' - 09/01 /G9 " ' -07/o 1 / 1 t3 X WC STATTII O?H- E.L. EACH ACCIDENT $1 OOO OOO E.L. DISEASE - EA EMPLOYEE $1 00O 000 E.L. DISEASE - POLICY LIMIT $1 000 000 OTHER DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS City of Fort Collins Utilities Department 700 Wood Street, Building A Fort Collins, CO 80521-0580 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL gyp_ DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR AUTHORIZED REPRESENTATIVE F76o04, 'r j04-fw­*S(5- I ,ri�►S.sr+ lt1s , Jajc. ACORD 25 (2001108) 1 Of 2 #S496807/M496774 JZS © 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-S (2001108) 2 Of 2 #S496807/M496774