Loading...
HomeMy WebLinkAbout116519 MAXWELL PRODUCTS INC - INSURANCE CERTIFICATE (2)OP ID: CV ACORO° CERTIFICATE OF LIABILITY INSURANCE �-! oaTDvrvv) 05110111 osn on 1 5110 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 .p certificate4tolder in lieu of such endorsements . I E f'."1. PRODUCER":•-^ .. i._�Tr-'' I801-924-1400 The Presidio Group,'Inc:,'Iee I,', I; 601-924-1441 5295South-300 Wes£-#550— ---_, I Salt Lake City, UT 84107 -- - - Alan W. Lord CIC, CWCA r ` - CONTACT •: rb' 1 ! '. J..: PHONE j H. U'^'I"- '-6%4 (FAX)AIC No.Eat E-MAIL' r,��+ ,,,, ",yl. I] ;r,•t.:; ADDRESS: PRODUCER MAXPRI C STOMERIDN:- ' INSURERS AFFORDING COVERAGE NAIC If INSURED Maxwell Products, Inc. 650 S Delong Street Salt Lake City, UT 84104 INSURER A:Ironshore Insurance Ltd. INSURERB:Colorado Casualty Insurance 41785 INSURER C:Employers Insurance Group 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 INOICATFD. 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 R TYPE OF INSURANCE A POLICY NUMBER EFF MMIDDYIYYYY MMIDD� LIMITS A t. - - GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS-MADF,❑X OCCUR ,Ia 000228001 -- 'Y-� r -�.• ,, _a_•� r y. _ 04/06/11 - — _ --_ 04/05/12 _^ '- EACH OCCURRENCE $ 2,000,00 PREMISES Ea occunence 8 600,00 MED EXP(Any one person) It 25,00 PERSONAL ItADVINJURY $ 2,000,00 GENERAL AGGREGATE S 4,000,00 GEN'CAGGREGATE LIMIT APPLIES PER: POLICY PRO- 9QTLOC PRODUCTS - COMP/OPAGG S 2,000,00 POIIUtIOn $ 2,000,00 '- B'. AuTomoBiCEIJABILITYI - A- - _ " ` --. ALL OWNED AUTOS - SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS ' BA8683295 ` '" "- 06h 2110 06112/11 - COMBINED SINGLE LIMIT (Ea a=idenl) $ 1,000,00 - BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ X PROPERTYttidwt)DAMAGE (Peraident) S X X S UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS MADE I EACH OCCURRENCE $ JAGGREGATE $ DEDUCTIBLE RETENTION $ $ $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY �A..:'P--,OPRIETO�ARTNERr XECUTIVE YIN OFFICERIMEMBER EXCLUDED? ❑ (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below NIA FN0329778-06 08I01I10 08I01111 X VJC STATU- EER E.L. EACH ACCIDENT $ 100,00 E.L. DISEASE - EA EMPLOYEE $ 100,00 E.L. DISEASE -POLICY LIMIT 1 $ 500,00 B Inland Marine IM8696815 06/12/10 06112111 Equipment 177,60 Ded 1,00 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) Subject to the terms and conditions of the policy. City of Fort Collins is additional insured as respects general liability per form 94358 04/07 attached. JOB: 6080 Crack Seal Mathrial CITYFOR City of Fort Collins Purchasing Division PO Box 580 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 4 Sip—?- ©1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009109) The ACORD name and logo are registered marks of ACORD OP ID: CV 4��Ro CERTIFICATE OF LIABILITY INSURANCE PATE 05110/11 YYI 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 termsand conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the,, certi6ca6holder in:lieu"of such endorsement(s)r - - ,PRODUCER--,w� 1 .t -[R h^t 1801-924-1400 The Presidio Group; Inc t 4'i441 5295 South 300 West #550- Salt Lake City, UT 84107. Alan W. Lord CIC, CWCA ,' CONTACT NAME:• PHONa FAX.c_1801-92I a: E-MAIL -___` _• _- __ _ _ • _ ,:-i:;"-<:L PRODUCER CUSTOMERID#:'MAXPRI INSURER(SJ AFFORDING COVERAGE NAIC p INSURED Maxwell Products, Inc. INSURER A:Ironshore Insurance Ltd. 650 S Delong Street INSURERB:Colorado Casualty Insurance 41785 Salt Lake City, UT 84104 INSURER C:Employers Insurance Group 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 TYPE OF INSURANCE POLICY NUMBER MMILDDY� MM/DD//YY Y LIMITS GENERAL LIABILITY CURRENCE $ 2,000,00 S Ea occurrence $ 500,00 A X COMMERCIALGENERALLIABILITY X 000228001 04/05111 04/06/12 CLAIMS -MADE OCCUR -- tMEDEXP(Anyone person) S "'25,00L S ADV INJURY ._2,000,00y ... :;., ' AGGREGATE _. S4,000,001 ,;. . -... .___. - - _-_�......... _. _.—. —_ - .. .._TS .... .... ...ouon ,GENL AGGREGATE LIMIT APPLIES PER RtA Y 9PRO=�'.LOC...-�._...;._....-...-.__—_. COMP/OP-AGG $. 2,000,00.•: _.._ ... $ 2,000,00 ;(1 B� AUTOMOBILE LIABILITY_,�•:Ji.. _ .. _ ANY.AUTO - .. — --, . -.. BA8683295', .._ •06/12/10 �06112111 COMBINED SINGLE LIMIT (Ea accident) - •' . $ 1000,00 BODILY INJURY (Per person) $ ALL OWNED AUTOS - BODILY INJURY (Per accident) S X SCHEDULED AUTOS HIREDAUTOS PROPERTY DAMAGE (Per accident) $ X X $ NON -OWNED AUTOS - $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DEDUCTIBLE $ S RETENTION $ C — AND EMPS YERS' LL A Il IT AND EMPLOYER$' LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE F— OFFICER/MEMBER EXCLUDED? (Mandatory In NH) N/A FN0329778-06 08/01/10 08/01/11 X TOR VaC SLIMITSER E.L. EACH ACCIDENT $ 100,00 E.L. DISEASE - EA EMPLOYEE $ 100,00 Hrs, describe under DE SCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 500,00 B Inland Marine IM8696815 06112/10 06/12/11 Equipment 177,60 Ded 1,00 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, I1 more apace Is required) Subject to the terms and conditions of the policy. City of Fort Collins is shown as additional insured as respects general liability per form 94358(4107)attached. CITYFOR City of Fort Collins Purchasing Division PO Box 580 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 © 1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009/09) The ACORD name and logo are registered marks of ACORD