HomeMy WebLinkAbout103910 ARAGON IRON & METAL INC - INSURANCE CERTIFICATE (4)c
INSR ADD'L
LTR INSRD
DATE (MM/DD/YYYY)
PRODUCER
INSURED
POLICY EFFECTIVE POLICY EXPIRATION
TYPE OF INSURANCE POLICY NUMBER DATE (MM/DD/YY) DATE (MM/DD/YY) LIMITS
GENERAL LIABILITY
AUTOMOBILE LIABILITY
GARAGE LIABILITY
EXCESS/UMBRELLA LIABILITY
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY
OTHER
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 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
REPRESENTATIVES.
AUTHORIZED REPRESENTATIVE
ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICER/MEMBER EXCLUDED?
INSURER A:
INSURER B:
INSURER C:
INSURER D:
INSURER E:
EACH OCCURRENCE $
DAMAGE TO RENTED
COMMERCIAL GENERAL LIABILITY PREMISES (Ea occurrence) $
CLAIMS MADE OCCUR MED EXP (Any one person) $
PERSONAL & ADV INJURY $
GENERAL AGGREGATE $
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $
PRO-
POLICY JECT LOC
COMBINED SINGLE LIMIT $
ANY AUTO (Ea accident)
ALL OWNED AUTOS BODILY INJURY
(Per person) $
SCHEDULED AUTOS
HIRED AUTOS BODILY INJURY
(Per accident) $
NON-OWNED AUTOS
PROPERTY DAMAGE $
(Per accident)
AUTO ONLY - EA ACCIDENT $
ANY AUTO OTHER THAN EA ACC $
AUTO ONLY: AGG $
EACH OCCURRENCE $
OCCUR CLAIMS MADE AGGREGATE $
$
DEDUCTIBLE $
RETENTION $ $
WC STATU- OTH-
TORY LIMITS ER
E.L. EACH ACCIDENT $
E.L. DISEASE - EA EMPLOYEE $
ACORD 25-S (2001/08)
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).
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.
DISCLAIMER
IMPORTANT
2 of 2 #S522860/M506414
If yes, describe under
SPECIAL PROVISIONS below E.L. DISEASE - POLICY LIMIT $
O
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.
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 #
COVERAGES
CERTIFICATE HOLDER CANCELLATION
ACORD 25 (2001/08) ACORD CORPORATION 1988
ACORDTM CERTIFICATE OF LIABILITY INSURANCE 4/14/2010
Flood & Peterson Insurance Inc
Corporate Mailing Address:
P. O. Box 578
Greeley, CO 80632
Aragon Iron & Metal Corp
516 Highway 287, North
Fort Collins, CO 80524
Granite State Insurance
National Union Fire Insurance
Pinnacol Assurance
A
X
X
X
02LX0062627252 10/01/09 10/01/10
2,000,000
2,000,000
1,000,000
1,000,000
300,000
10,000
A
X
X
X
X Drive Other Car
02CA0062696972 10/01/09 10/01/10
1,000,000
B
X
X 10000
01UD0004075362 10/01/09 10/01/10 2,000,000
2,000,000
C 3081185 03/01/10 03/01/11 X
1,000,000
1,000,000
1,000,000
Certificate Holder is listed as an Additional Insured.
City of Fort Collins
PO Box 580
Fort Collins, CO 80522
30
10 Days for Non-Payment
1 of 2 #S522860/M506414
Client#: 12935 ARAIR
JZS