HomeMy WebLinkAbout471324 ALPINE WORKS INC - INSURANCE CERTIFICATEACORD. CERTIFICATE OF LIABILITY INSURANCE o2;i;;2o '
PRODUCER (970) 484-2805 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
John C. Beckett & Associates, Inc. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
220 Smith Street ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
-Collins CO "80524— "INSURERS AFFORDING COVERAGE
'INSURED i F INSURER A:ADDISON FARMERS INS" CO,:..,_
Alpine; Works ; +a Inc :< INSURER B:
'P . O. Box 1,93,6,iu::lp i INSURER C: z
F
INSURER D:
Fort Collins . o zF. ,` CO 80522- INSURER E.
:UUVtKA"tJ
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
ADD'L
INSRD
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
DATE (MMIDDNY)
POLICY EXPIRATION
DATE (MMIDDIYY)
LIMITS
A
GENERAL LIABILITY
X COMMERCIAL GENERAL LIABILITY
X CLAIMS MADE OCCUR
PENDING
02/06/2010
02/06/2011
EACH OCCURRENCE
$ 1,000,000
DAMAGES ( ence) RENTED
PREMISES Ea occurr
$ 100,000
MED EXP (Any one person)
$ 5,000
PERSONAL &ADV INJURY
$ 1,000,000
HGE�'L
GENERAL AGGREGATE
$ 2,000,000
AGGREGATE LIMIT APPLIES PER:
PRODUCTS - COMP/OP AGG
$ 2,000,000
EBLIA
POLICY X JECOT LOC
A
AUTOMOBILE
LIABILITY.
PENDING -
02/06/2010
02/06/2011
COMBINED SINGLE LIMIT
(Ea accident)
$ 1,000,000
ANY AUTO
BODILY INJURY.. .. .-
person)..._
$ --
OWNED AUTOS t ";
i."
�.:
-✓-.�. ..
X
SCHEDULED AUTOS
-BODILY INJURY"'
.(Per accident)_.....
_.._. ..-,.....-...
.,
.tiy:':"
HIREDiAUTOS
. -.,::-I-..,.�?-- _.
_ --- -- - -.
_�_-I-.....�- -----
_....__... __-..._.-_
"NON`-OWNED'AUTOS
r
...
PROPERTY DAMAGE -
(Per
GARAGE LIABILITY
AUTO ONLY - EA ACCIDENT
$
OTHER THAN EA ACC
AUTO ONLY: AGG
$ .
ANY AUTO
-
$
EXCESS/UMBRELLA LIABILITY
EACH OCCURRENCE
$
AGGREGATE
$
OCCUR CLAIMS MADE
$
DEDUCTIBLE
/ /
$
RETENTION $
WORKERS COMPENSATION AND
� �
� �
WC STATU- OTH-
TORY LIMITS ER
E.L. EACH ACCIDENT
$
EMPLOYERS' LIABILITY
ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICER/MEMBER EXCLUDED?
E.L. DISEASE - EA EMPLOYEE
$
E.L. DISEASE -POLICY LIMIT
$
If yes, describe under
SPECIAL PROVISIONS below
OTHER INMRC
PENDING
02/06/2010
02�06�2011
DESCRIPTION OF OPERATIONS/LOCATION SNEHICLESIEXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
City of Fort Collins is an additional insured on the General Liability policy as their interest may appear.
CERTIFICATE HULUEK l,N1Y liGLLM I IV11
( ) - (970) 224-6134 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES .BE CANCELLED BEFORE THE
Purchase & Risk Managment EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL
010 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT
City of Fort Collins FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE
215 N . Mason INSURER, ITS AGENTS OR REPRESENTATIVES.
Second Floor AUTHORIZED REPRESENTATIVE I
Fort Collins CO 80524-
ACORD 25 (2001/08) V M%Ivr%J %IVfRrVnrl I IVn lave
*1n INS025 (0108).05 ELECTRONIC LASER FORMS, INC. - (800)327-0545 Page 1 of 2