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HomeMy WebLinkAbout103009 PORTER INDUSTRIES INC - INSURANCE CERTIFICATE (22)rrnnfli- 1AAnq ACORD.. " CERTIFICATE OF LIABILITY INSURANCE DATE ) 12/13/2010 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 CO TA NAME: c Kelly Beauvais Flood & Peterson Ins., Inc. PHONE 970 266-7121 FAX 970 506-6846 AIC No Ext : (A/C, No): Corporate Mailing Address: E-MAIL Bis f Insurance.com ADDRESS: Kelly.Beauvais@fpinsurance.com P. O. Box 578 PRODUCER Greeley, CO 80632 CUSTOMER ID #: INSURERS) AFFORDING COVERAGE NAIC # INSURED INSURER A: Travelers Insurance Company Porter Industries, Inc. & Assurance Porter Industries, Inc. dba Maid Clean INSURER BPinnacol 5202 Granite Street INSURER C Loveland, CO 80538 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. INSR LTR I TYPE OF INSURANCE DDL NSR SUBR D I POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DD/YYYY LIMITS A GENERAL LIABILITY XI COMMERCIAL GENERAL LIABILITY CLAIMS -MADE FxI OCCUR P6308107CO30TIL10 07/01/2010 07/01/2011 EACH OCCURRENCE $1,000,000 DA AGE To RENTE PREMISES (E. occur ence) s300,000 MED EXP (Any one person) $10,000 PERSONAL & ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO LOC PRODUCTS - COMP/OP AGG $2,000,000 $ A AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS P8108107CO30TIL10 07/01/2010 07/01/2011 COMBINED SINGLE LIMIT (Ea accident) $1,000,000 X BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ X X $ $ A UMBRELLA LIAB EXCESS LIAB I X I OCCUR CLAIMS -MADE - PSMCUP8107CO30TILl - 07/01/2010 07/01/2011 EACH OCCURRENCE $1,000,000 rl AGGREGATE $1,000,000 DEDUCTIBLE � RETENTION 1000 $ _X - - $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROP RI ETOR/PARTNER/EXECUTIVE 7 OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N/A 4038253 07/01/2010 07/01/2011 X WCSTATU- OTH- E.L. EACH ACCIDENT $1,000,000 E.L. DISEASE - EA EMPLOYEE $1,000,000 E.L. DISEASE - POLICY LIMIT $1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) RE: Carpet Maintenance 199iIIIIIIIi10"111 WE 11 LVNI U 4 0 City of Fort Collins PO Box 580 215 N Mason St Second Floor Fort Collins, CO 80522 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ACORD 25 (2009/09) 1 of 1 #S578197/M577037 ©1988-2009 ACORD CORPORATION. All -rights reserved. The ACORD name and logo are registered marks of ACORD r1w.