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Home My WebLink About253179 GRAFFITTI'S INC - INSURANCE CERTIFICATE� �: W /�l`IJ�CERTIFICATE OF LIABILITY INSURANCE OP ID KA DATE (MM/DD/YYYY) 01/13/11 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 O Box 2226 NAME: FAX (EaCNo Ext): (A/C, No): ADDRESS: CUSTDOMERID#: GRAFF-1 Fort Collins CO 80522-2226 Phone:970-482-7747 Fax:970-484-4165 INSURER(S) AFFORDING COVERAGE NAIC# INSURED INSURER A: Pinnacol Assurance Company 41190 Graffittils Inc. dba: Mikers Hauling & Cleanup Service PO Box 7 634 Loveland CO 80537-0634 INSURERB: Argonaut -Midwest Insurance Co. 19828 INSURER C : Colony Specialty Insurance Co. 02619 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. LTR TYPE OF INSURANCE INSR WVD POLICY NUMBER POLICY EFFTPOLI (MM/DDIYYYY) (MM/DD/YYYY) LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1000000 C X COMMERCIAL GENERAL LIABILITY GL3636762 12/11/10 12/11/11 PREMISGESO-RENTEoccurrence) $ 100000 CLAIMS -MADE FX] OCCUR MED EXP (Any one person) $ 5000 PERSONAL & ADV INJURY I $ 1000000 GENERAL AGGREGATE $ 2000000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ Included PRO17 POLICY n ECT F LOC I $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident) $ 1000000 $ ANY AUTO TP8007230 12/11/10 12/11/11 BODILY INJURY (Per person) $ ALL OWNED AUTOS BODILY INJURY (Per accident) $ SCHEDULED AUTOS HIRED AUTOS PROPERTY DAMAGE (Per accident) $ NON -OWNED AUTOS $ Is B X I TRUCKERS I ITP8007230 12/11/10 12/11/11 UMBRELLA LIAR OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DEDUCTIBLE $ $ RETENTION $- A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ECUTIV� 4007823 01/01/11 01/01/12 ITORYLIMiTS ER E.L.EACH ACCIDENT $ SOOOOO OANY FFICER/MEMBER ER EXCLUDED (Mandatory in NH) NIA E.L. DISEASE -EAEMPLOYEEi1 $ 500000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT 1 $500000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) Garbage, Ash or Refuse Collecting CERTIFICATE HOLDER CANCELLATION City of Fort Purchasing 281 N College Fort Collins Collins Avenue CO 80522 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE C I TYFT5 I THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. ]�8�- 0 RATION. All rights reserved. ACORD 25 (2009/09) The ACORD name and logo are regi ed marks of CORD