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HomeMy WebLinkAboutPEAK ELEVATOR PERFORMANCE GROUP - INSURANCE CERTIFICATE (3)SKOSTER ,a�o�zo CERTIFICATE OF LIABILITY INSURANCE;" < < DATE(MMADVYY) ' -3/2212011 ' 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-CE-C ERTIFICATE ICATE OF INSURANCE DOES NOT-CONSTITUTE-A'CONTRACT, BETWEEN ;THE ISSUING INSURER(S), AUTHORIZED' REPRESENTATIVEOR_PRODUCER, AND THE CERTIFICATE HOLDER'. IMPORTANT: lf, 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 CeBiz Insurance, Inc. - CO 82117th SL Denver, CO 80202 CONTACT NAME: Jeremy Tom PHONE 303 988-0446 FAX ac Na all, ) uc No: (303) 988-0804 AooREss: jtom@cobizinsurance.com PRODUCER CUSTOMPEAKELE-01 ER ID O' INSUI AFFORDING COVERAGE NAIL 0 INSURED INSURER A: Scottsdale Insurance Company Peak Elevator Perlorman Ce Group Inc. INSURER B: Cincinnati Casualty CO 28665 5156 W 58th Ave Suite B INSURER c: Plnnacol Assurance 41190 INSURER Arvada, CO 80002 INSURER E : 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 TYPE OF INSURANCE!:;; vf'- ADDL '--I1s�r':1VOLICY NUMBER MMIDOY MMI00/YEYYY LIMITS (. � A GENERALLIABILITY-..... .1: ...• COMMERCIALGENERALLABILITY i -- CLAIMS MADE"�X 'OCCUR -'- 24 --- - — /20I212 EACH OCCURRENCE - - S . 2,000,000 UA PREMISES EH"Itunf. I$. "I '100,00 MED EXP(Any one parson) F S _4.T`' 5,00 PERSONAL S ADV INJURY • S' _ 2,000,00 - GENERAL AGGREGATE $ 4,000,00 GEN•L AGGREGATE LIMIT APPLIES PER: POLICY X PRO LOC PRODUCTS - COMPIOPAGG S 4,060,00 $ B AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS CAP5214843 - 3/20I2011 3/20/2012 COMBINED SINGLE LIMIT (Ea accident) b 1,000,000 X BODILY INJURY (Par person) $ BODI LY INJURY (Par accidmt) $ PROPERTY DAMAGE (Per i dddenC S $ S A X UMBRELLA LAS EXCESSLIAB X OCCUR CLAIMS -MADE XLS0073157 3/2012011 3120/2012 EACH OCCURRENCE is 21000,00 AGGREGATE S 2,000,00 DEDUCTIBLE RETENTION $ E $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITYC ANY PROPRIETORIPARTNEWEXECUTIVE YIN OFFICERIMEMBER EXCLUDED? ❑ (Multistory In NH) II yes, deSGibe under DE SCRIPTION OF OPERATIONSbil NIA 1483372 $1112010 5/1/2011 X WC STATU- OTH- E.L. EACH ACCIDENT $ 1,000,000 E. L. DISEASEEAEMPLOYEE $ 1,000,000 E.L. DISEASE -POLICY LIMIT $ 1,000,00 DESCRIPTION OF OPERATIONS ILOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarlus ScMdub, it more space is Mulmd) SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City's Director of Purchase & Risk Management THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 215 N Mason 2nd Floor ACCORDANCE WITH THE POLICY PROVISIONS. Fort Collins, CO 80524 AUTHORIZED REPRESENTATIVE ©1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009/09) The ACORD name and logo are registered marks of ACORD