HomeMy WebLinkAboutGRAFFITTIS INC - INSURANCE CERTIFICATEACORD CERTIFICATE OF LIABILITY INSURANCE OP ID DATE(MM/DD/YYYY)
GRAFF-1 01/07/10
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Brown & Brown Inc ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
125 S Howes, 5th Floor HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
P O B 2226 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
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Fort Collins CO 80522-2226
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Phone: 970-482-7747 Fax: 970-484 �41.65 �; j, i
INSyURERS AFFORDING COVERAGE
NAIC #
INSURED ii I;' vU1I�'L`• 'J L-'
'INsuRERA: Pinnacol Assurance Company
41190 -
1 r ,�� rl ke��)•$.V 4 2010
Graffitti s Inc. dba: I
Hauling- & Cleanup Servi�ce�
,INSURER B: Argonaut -Midwest Insurance Co.
19828
1 A ',
wsuRERc: Colony Insurance Company
39993 -.- -
INSURER0:
PO BOX 7634
Loveland CO 80537-0634
;
INSURER E:
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.
IASR'ADO
LTR INSRD
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
DATE MMIDD/YY
POLICY EXPIRATION
DATE MM/DD/YY
LIMITS
C
GENERAL LIABILITY
X COMMERCIAL GENERAL LIABILITY
CLAIMS MADE 1K OCCUR
GIL3 63 67 62
12 / 11 / 10
12 / 11 / 11
EACH OCCURRENCE
$ 1000000
1AMAGI= T6RENT
PREMISES (Ea occurence)
$ 100000
MED EXP (Any one person)
$ 5000
PERSONAL & ADV INJURY
$ 1000000
GENERAL AGGREGATE
$ 2000000
GEN'L AGGREGATE LIMIT APPLIES PER:
POLICY JECT LOC
PRODUCTS - COMP/OP AGG
$ Included
B
B
AUTOMOBILE
LIABILITY
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON -OWNED AUTOS
TRUCKERS
TP8007230
_
12/11/10
12/11/11
COMBINED SINGLE LIMIT
(Ea accident)
$ 1000000
BODILY INJURY
(Per person)
$
BODILY INJURY
(Per accident)
$
X
PROPERTY DAMAGE
accident)
$
ri(Per
GARAGE LIABILITY
ANY AUTO
AUTO ONLY - EA ACCIDENT
$
OTHER THAN EA ACC
AUTO ONLY: AGG
$
$
EXCESSIUMBRELLA LIABILITY
OCCUR CLAIMS MADE
DEDUCTIBLE
RETENTION $
EACH OCCURRENCE
$
AGGREGATE
$
$
$
$
A
WORKERS COMPENSATION AND- -
EMPLOYERS' LIABILITY
ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICER/MEMBEREXCLUDED?
If yes, describe under
SPECIAL PROVISIONS below
-
4007823
-
01/01/10
01/01/11
TORY LIMITS ER
E.L. EACH ACCIDENT
$ 500000
E.L. DISEASE - EA EMPLOYEE
$ 500000
E.L. DISEASE - POLICY LIMIT
$ 500000
OTHER
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS
Garbage, Ash or Refuse Collecting
CERTIFICATE HOLDER CANCELLATION
CITYFT5
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN
City of Fort Collins
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
Purchasing
281 N College Avenue
IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
Fort Collins CO 80522
REPRESENTATIVES.
AUTHORI REPRESENTATIVE
Jy-
ACORD 25 (2001/08) IrR/ �„y fGXf 6VI U ACORD GURPURA i IVN 191515