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HomeMy WebLinkAbout103009 PORTER INDUSTRIES INC - INSURANCE CERTIFICATE (19)Fax Server 6/29/2010 1:18:40 PM PAGE 2/003 Fax Server efianftt• iaans Fn=nT. ACORDTM CERTIFICATE OF LIABILITY INSURANCE 0&29/2010"""' PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Flood & Peterson Ins., Inc. Corporate Mailing Address: Po g ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. P. 0. Box 578 Greeley, CO 80632 INSURERS AFFORDING COVERAGE NAIC # INSURED INSURER A: Travelers Insurance Company Porter Industries, Inc. 5202 Granite Street Loveland, CO 80538 INSURER B: Pinnacol Assurance INSURER C: INSURER D: INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TOTHE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECTTO 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. LTR SR TYPE OF INSURANCE POLICYNUM13ER DATEi MIUDNI) XPI PDA MM/DD//YION LIMITS A GENERAL LIABILITY P6308107CO30TIL1 07/01/10 07/01/11 EACH OCCURRENCE $1 000 000 NCOM MERCIAL GENERAL LIABILITY CLAIMS MADE a OCCUR DARMAGE TO RENTEDance) $300OOO ME EXP (Any one person) $1 O 000 PERSONAL & ADV INJURY $1 000 Q00 GENERAL AGGREGATE $2 00O 000 GEN'LAGGREGATE LIMIT APPLIES PER : PRODUCTS - COMP/OPAGG $2000000 POLICY PRO- LOC JE A AUTOMOBILE LIABILITY X ANYAUTO P8108107CO30TIL1 07/01/10 07/01/11 COMBINED SINGLE LIMIT (Ea accident) $1,000,000 BODILY INJURY (Per person) $ ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY (Per accdeni) $ X HIRED AUTOS X NON -OWNED AUTOS PROPERTY DAMAGE (Per acddant) $ GARAGE LIABI LITY AUTO ONLY - EA ACCIDENT $ OTHER THAN EAACC $ ANYAUTO $ AUTO ONLY: AGG A EXCESS/UMBRELLA LIABILITY PSMCUPS107CO30TI 07/01/10 07/01/11 EACH OCCURRENCE $1 00O 000 X I OCCUR CLAIMS MADE AGGREGATE $1 OOO 000 $ DEDUCTIBLE $ X RETENTION $ 10000 B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE 4038253 07/01/10 07/01/11 X WC STAT U- CER T RY IhQIT R E.L. EACH ACCIDENT $1 00O 000 E.L. DISEASE -EA EMPLOYEE $1 000,000 OFFICER/MEMBER EXCLUDED? Ifyes,describeunder SPECIAL PROVISIONS below E.L. DISEASE - POLICY LIMIT $1 00O 000 OTHER DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS City of Fort Collins is listed as an Additional Insured as their interest may appear as respects General Liability. City of Fort Collins Purchasing Department PO Box 580 Fort Collins, CO 80524 SHOULD ANY OFTHE ABOVE DESCRIBED POLICIES BECANCELLED BEFORETHE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 1111 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 AUTHORIZED REPRESENTATIVE �' 7 ill ChR� � i'" •%ram' � �l�.i oL ��1✓/� aOraA.�G.A J .�/`�;�' . ACORD 25 (2001/08) 1 of 2 #S540397/M540361 JZS © ACORD CORPORATION 1988 Fax Server 6/29/2010 1:18:40 PM PAGE 3/003 Fax Server 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. AUUKU 20-s (2001/08) 2 of 2 #S540397/M540361