HomeMy WebLinkAbout103133 BOB'S APPLIANCE SERVICE - INSURANCE CERTIFICATEA OW CERTIFICATE OF LIABILITY INSURANCE DATE(MMmONVYYY)
OP ID LD 03131 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 po es must be endorsed. I N IS WAIVED, subject to
the terms and conditions of the policy, certain policies may require an endorsement. Astatement on this certificate does not confer rights to the
certificate holder in lieu of such endorsement(s). -
PRODUCER
Brown 6 Brown Inc
NAME:
C No Ert: (ANC, No):
125 S Howes, 5th Floor
.(
ADDRESS:
P O Box 2226
Fort Fort Collins CO 80522-2226PR0Du
IO CUSTOMERM: BOBSA-1
Phone:970-482-7747 Fax:970-484-4165
INSURER(S) AFFORDING COVERAGE
NAIC0
INSURED
INSURER A: o.paeicors Tnsuzanc. c®pany
42587
Bob's Appliance SerVlce
International Ventures Inc DBA
INSURER B:
INSURER C:
225 Smokey St
Ft Collins CO 80525
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 CLAMS.
ILTSR
TYPE OF INSURANCE
AODUSUR
INSRI
WVD POLICY NUMBER
POLIPODCY
(MMmDIYYYY)I(MMmO/YYYY)
EXP
UMTS
A
GENERAL LIABILITY
COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE OCCUR
X Business Owners
ACP7514462047
05/01/11
05/01/12
-
EACH OCCURRENCE
s2000000
PREMSE$ P occunence)
s300000
MED UP (My one person)
$5000
PERSONAL BADVINJURY
s2000000
GENERAL AGGREGATE
$ 4000000
GEN'L AGGREGATE LIMIT APPLIES PER:
POLICY jEa LOC
PRODUCTS - COMP/OP AGG
$4000000
$
A
AUTOMOBILE
LIABILITY
ANY ADro
ALL OWNED AUTOS
SCHEDULED AUTOS
HIREDALTrOS
NON-OWNEDAUrOS
ACP7514962047
05/01/11
os/ol/lz
COMBINED SINGLE LIMB
(Ea acadent)
$1000000
BODILY INJURY(PW person)
$
BODILY INJURY (Per actidenQ
$
PROPERTY DAMAGE
(Per accident)
$
X
X
$
$
UMBRELLA UAB
EXCESS LIM
OCCUR
CLAIMS -MADE
-
EACH OCCURRENCE
$
AGGREGATE
$
DEDUCTIBLE
RETENTION $
$
$
WORKERS COMPENSATION
AND EMPLOYERSLIABILITY YIN
ANY PROPRIETOWARTNERi ECUT
OFFICEWMEMBER EXCLUDED?
(Mandatory in NH) I
DESCRIPTION OF OPERATIONS babe
NIA
-
I TORY LIMBS I I ER
EL EACH ACCIDENr
$
E.L DISEASE -EA EMPLOYEE
$
E.L DISEASE - POLICY LIMIT 1 $
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (AtUW ACORD 101, AddlUonal Remarb Schedule, N mare apace Is meulrod)
YCn„flr.N,a n,vo,m �CLLA I IVNY
CITYOF I SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WALL BE DE WERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
City of Fort Collins
P.O. Box 580
rinMc ,aecerverl
ACORD 25 (2009109) The ACORD name and logo are registered marks of ACORD