HomeMy WebLinkAboutCOLORADO SASH & DOOR INC - INSURANCE CERTIFICATE (2)A
OW CERTIFICATE OF LIABILITY INSURANCE OP ID LD
DATE(MMIDDNYYY)
05/20/11
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: e certificate holder Is an ADDITIONAL INSURED, the poll ies must be endorsed. , 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 S Brown Inc
NAME:
,
IENC No,Ert): (Alt, No):
125 S Howes, 5th Floor
P 0 Box 2226
ADDRESS:
Fort Collins CO 80522-2226
CUSTOMER
CUSTOMER ID R: CDSAS-1
Phone:970-482-7747 Fax:970-484-4165
INSURERS) AFFORDING COVERAGE
NAICIf
INSURED
INSURERA: AMCO Insurance Company
19100
Colorado Sash S Door, Inc
P. 0. Box 270682
INSURERS: Depositors in-c. company
42587
INSURERC: Pinnacol Assurance Company_
41190
Fort Collins CO 80527
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
INSRI
Me
POLICY NUMBER
FT
(MMND�
I POLICY DIP
LIMITS
GENERAL LIABILITY
EACH OCCURRENCE
$ 1000000
A
COMMERCIAL GENERAL LIABILITY
ACP7514152079
12/08/10
12/08/11
REM ED
PREMISSES(Eacaunenca
$ 300000
CI -AIMS -MADE ❑X OCCUR
MED EXP(Any one person)
$ 5000
PERSONAL B,IDV INJURY
$ 1000000
X Business Owners
X
GENERAL AGGREGATE
$ 2000000
GENL AGGREGATE LIMIT APPLIES PER:
PRODUCTS - COMP/OPAGG
$2000000
POLICY n JER° F7 LOC
$
AUTOMOBILE
LIABILITY
COMBINED SINGLE LIMIT
(Ea accident)
$ 1000000
B
X
ANYAUro
ACP7514152079
12/08/10
12/08/11
BODILY IWURY(Per person)
S
ALL OWNED AUTOS
BODILY INJURY(Per accident)
$
SCHEDULED AUTOS
HIRED AUTOS
PROPERTY DAMAGE
(Per accident)
S
NOWOWNED AUTOS
S
S
A
X
UMBRELLA LNB
}( OCCUR
ACP7514152079
12/08/10
12/08/11
EACH OCCURRENCE
$ 1000000
EXCESS LIAB
CLAIMS -MADE
AGGREGATE
$ 1000000
hDEDUCTIBLE
S
_
$
X
RETENTION $ 0
C
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY YIN
OMy FFICERPRIETOREXCLUDRrEED? EC<nNE
(Mandatary In NH)
N/A
4024240
06/01/11
06/01/12
X�Lj�MITSTU- TH
E.L EACH ACCIDENT
$ 500000
E.LOISEASE.EAEMPLOYE
$500000
U yes, de n:nhe under
DESCRIPTION OF OPERATIONS belowE.L
DISEASE - POLICY LIMIT
I $500000
DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (Attach ACORD 101 AdditionaI Remarks Schedule, If more space Is required)
City of Fort Collins is included as additional insured on the general
liability.
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLI
UTILFTC I THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
City of Fort Collins
Utility Department
700 Wood St.
ACORD 25 (2009109) The ACORD name and logo are regislered marks of ACORD