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Home My WebLink AboutCUSTOM SERVICES OF COLORADO INC - INSURANCE CERTIFICATEA RD CERTIFICATE OF LIABILITY INSURANCE 03ii2/z010 PRODUCER (970)679-7333 FAX (866)456-4265 Ewing -Leavitt Insurance Agency 4025 St. Cloud Dr. Suite 100 Loveland, CO 80538 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE NAIC # INSURED Custom Services of Colorado, Inc. 796 Abrams Wy Loveland,-C-0 80537 INSURER A: Secura Insurance=r-':•:•-o - • INSURERB: Pinnacol Assurance..,:, 41190 INSURERC: 1 INSURER D: INSURERE: r . . ..... ... 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 ADDT TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION DATE (MMIDDNYI LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS MADE OCCUR X Blanket Add r 1 Ins 3160361 03/29/2010 03/29/2011 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED $ 100,000 MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY _ $ 1,000,000 X Blanket Wvr of Sub GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY X PRO LOC JECT PRODUCTS - COMP/OP AGG $ 2,000,000 A_ AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS 3160362 03/29/2010 •:�.,__ 03/29/2011 - COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 X BODILY INJURY' (Per person) $ _ .... X BODILY INJURY (Per accident) X PROPERTY DAMAGE (Per accident) $i GARAGE LIABILITY-, `_':, + ANY AUTO'-` -- - - - _ -__ ., - - - - AUTO ONLY - EA ACCIDENT $ ` OTHER THAN EA ACC AUTO ONLY: AGG $ $ A EXCESS/UMBRELLA LIABILITY X OCCUR CLAIMS MADE DEDUCTIBLE X RETENTION $ 10,00 3160363 03/29/2010 03/29/2011 EACH OCCURRENCE $ 1,000,000 AGGREGATE $ 1,000,000 $ $ $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIFTOR/PARTNER'EXECUTIVF OFFICER/MEMBER EXCLUDED? If yes, describe under SPECIAL PROVISIONS below 4025555 01/01/2010 01/01/2011 X I WCSTATU_ OTH- E.L. EACH ACCIDENT $ 1,000,000 --.---. E.L. DISEASE - EA EMPLOYEE _ $ 1,000,000 E.L. DISEASE - POLICY LIMIT $ 1,000,000 OTHER DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS ity of Ft. Collins is shown as additional insured. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL City Of Ft. Collins 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, 256 W . Mountain Avenue BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY P . 0. BOX 580 OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. Ft. Collins, CO 80522-0580 AUTHORIZED REPRESENTATIVE Christy Herbert ACORD 25 (2001/08) ©ACORD CORPORATION 1988 ACORDM CERTIFICATE OF LIABILITY INSURANCE 03/12/2010 PRODUCER (970)679-7333 FAX (866)456-4265 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Ewing -Leavitt Insurance Agency ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 4025 St. Cloud Dr. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Suite 100 Loveland, CO 80538 INSURERS AFFORDING COVERAGE NAIC # INSURED Custom Services of Colorado, Inc. - INSURER A: Secura Insurance 796 Abrams Wy INSURERB: Pinnacol Assurance 41190 Loveland, CO 80537 INSURER C: ......r.. ..... _ _ _JNSURER D: _ .. INSURER E: _ rnvccAn=C 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 ADDT TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS MADE FX] OCCUR X Blanket Add r l Ins 3160361 03/29/2010 03/29/2011 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED $ 100,000 MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $ 1,000,000 X Blanket Wvr of Sub GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY X PROJECT LOC PRODUCTS - COMP/OP AGG $ 2,000,000 A i AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS 3160362 03/29/2010 03/29/2011 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 EXCESS/UMBRELLA LIABILITY X OCCUR CLAIMS MADE DEDUCTIBLE X RETENTION $ 10,00 3160363 03/29/2010 03/29/2011 EACH OCCURRENCE $ 1,000,000 AGGREGATE $ 1,000,000 $ $ $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? If yes, describe under SPECIAL PROVISIONS below 4025555 01/01/2010 01/01/2011 X I WCSTATU_ OTH- TORY LIMITS ER E.L. EACH ACCIDENT $ 1, OOO, UUU E.L. DISEASE - EA EMPL6YEEI $ 1,000,000 E.L. DISEASE - POLICY LIMIT $ 1,000,000 OTHER DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS 11 Operations / All Locations City of Fort Collins James L. Hume, Acting Director Director of Purchasing & Risk Mgmt. PO Box 580 Fort Collins, CO 80522-0580 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE Christy Herbert ACORD 26 (2001/08) ©ACORD CORPORATION 1988