HomeMy WebLinkAboutMCEVOY AND SONS INC. - INSURANCE CERTIFICATEAPR-12-2010 13:53 From:WESTERN INSURANCE 9704841453 To:9706749137 P.2/5
TV
-ACORD CERTIFICATE OF LIABILITY INSURANCE DATE
44/12/2010
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Western Insurance Services ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER_ THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
15,2o•'E. Mulberry Suite 140 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Forl,,Colllns CO 80524 INSURERS AFFORDING COVERAGE
1? McEvoy S Sone Inc. INsuRERA Continental Western Group
PO Box 2T8: I INSURERS:
: INSURER C:
Severance CO 80546 INSURER 0;
INSURER E:
COVERAGES
i
••'rHEPOLICIESOF INSURANCELISTEDBELOW HAVEBEENISSLIEDTOTHE INSUREDNAMEDABOVEFORTHEPOUCYPERIODINDICATED-NOTWITHSTANDING
ANX REQUIREMENT, TERM OR CONDITION OF ANY CONYRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR
MAY PERTAIN, THE INSURANCEAFFORDEDBY THE POLICIES DESCRIBEDHERE IN IS SUBJECT TOALL THETERMS. EXCLUSIONSANDCONOITIONs OF SUCH
'POLICIES.
AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR TYP6 OF INSURANCE POUCV NUM8ER POLICY EFFECTIVE POLICr EI[PIRATI LBIVTS
GENERAL
LIABILITY
EACH OCCURRENCE
41 000,000
A ,
COMMERCIAL GENERAL LIABILITY
MCP 2438992
04/19/2010
0411191201111
FIRE AMAGE An one Iue
8100,000
CLAIMS MADE, x] OCCUR
I
MEO LfAmy onn ereon
8-5 00
P RBONAL S ADV INJURY
$1,000,000
i2,000,000
GENERAL AGGREGATE
AGGREGATE LIMIT APPLIES PER.
PRODUCTS-COMP/OPAGG
f2,000,000
'GEML
POLICY PRO. LOC
•AUTOMOBILE
LIABILITY
A;
`:t
ANY AUTO
MCP 2438992
04/19/2010
04/19/2011
COMBINED SINGLE LIMB
(Ees mm) E1,000,000
ALL OWNEDAUT08
1
•• ••
BOO4YINJURY
X
SCHEDULED AUTOS
(Per Perpp,I) 8
•)�
'
HIRED AUTOS
BODILY INJURY
J<
NON-OWNEDAVY06
(Per,7wdm) :
PROPERTY OAMAW S
(Per 9wde'I)
+DAIiAOE LIABLLnT
I
AUTO ONLY - EA ACC, ENT
S
ANYAUTO'
OTHER THAN EAACC
S
AUTO ONLY: A(iG
8
.EXCESS LIABRITY
EACH OCCURRENCtr
S
OCCUR CLAIMS MADE
AGGREGATE
8
OEVIJIMULE
•
i
RETENTION 8
I
WdRKERS COMPENBJIRON AND
WC 3TATU. OTH-
.EMPLOYERS' U1A8IUTY
-,
E.L. EACH ACCIDENT
S
E.L. DISEASE - FA MPLOYEE
8
'
E.L. ISEASE • POLICY LIMIT
8
:•
•dTHEJt
,
DESCRIPTION OF OPERATIONSILOCATION&VD*CLESIEXCLUBKJNB ADDED BY ENDORSEMENTIBPEOIAL PROVISIONS
CER�GIFICATE HOLDER ADDITIONAL iMWREDG W6VRERLErTBR; _ CANCELLATION
City of Fort Collins
SNOULDANYOFTHE ABOVE °ESCRISEDPOLICIESBECANCELL68REFORETHE EXPIRATION
q P.O. BOX so
DATE THEREOF, THE 189UmO INSURER IMLL ENDEAVOR TO OWL 30 DAYS WRITTEN
Building Building 8 Zoning Dept.
Attn:g,
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
•, Fort Collins,. CO 8062,2
IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER. ITS AGENTS OR
REPRESENTATmES.
I
AUTHORIZED REPRESENTATIVE
,n
A„ ORD. 75-5 (7/97) ® ACORD CORPORATION 1988
APR-12-2010 13:53 From:WESTERN INSURANCE 9704841453 To:9706749137 P.3/5
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.