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HomeMy WebLinkAbout129796 SECURITY DOCUMENT DESTRUCTION - INSURANCE CERTIFICATE7 (M AtE4?FDr CERTIFICATE OF LIABILITY INSURANCE OP ID JD [—' DATE(MM/DD/YYYY) 11/22/10 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. 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). PRODUCER - •- Brown & Brown Inc 125 S Howes, 5th.. Floor P 0 BOX 2226 Fort Collins CO 80522-2226 NAME: PHONE (EA/c, No, Ext : (A/C, No): ADDRESS: -PRCER CUSTOMER OMERID#: SECURID Phone:970-482-7747 Fax:970-484-4165 INSURER(S) AFFORDING COVERAGE NAIC# INSURED INSURER A: Mountain States Mutual 14648 Security Document Destruction National. Recycling Inc DBA INSURERB: INSURERC: PO BOX 2472 Ft Collins CO 80522-2472 INSURER D : INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT 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. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INTR TYPE OF INSURANCE NSR WVD POLICY NUMBER (MM% D�YY) (MM/FF DD/YYYY) LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE ❑X OCCUR CPP011394805 11/21/10 11/21/11 EACH OCCURRENCE $1,000,000 PRE�M SESO(Ea occurrence) $ 100,000 MED EXP (Any one person) $ 10,000 PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PECRO LOC JT PRODUCTS - COMP/OP AGG $ Included $ A AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS 13AP011394805 11/21/10 11/21/11 CO accident) SINGLE LIMIT(Ea $ 1,000,000 '000'000 X BODILYINJURY(Perperson) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ $ $ A UMBRELLA LIAR EXCESS X OCCUR CLAIMS -MADE - UMB011394805 11/21/10 11/21/11 EACH OCCURRENCE $ 1 , 000 , 000 AGGREGATE $1,000.,000 DEDUCTIBLE RETENTION $ O _ $ _X_. $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIV130 OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below NIA _ WC STATU- OTH- TORY LIMITS ER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYE $ E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) CERTIFICATE HOLDER CANCELLATION City of Fort Collins John Stevens Purchasing Department PO Box 580 Fort Collins CO 80522 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE FTCPURC I THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ©1988-2009 ACORD CORPORATION. All rights reserved ACORD 25 (2009/09) The ACORD name and logo are registered marks of ACORD