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HomeMy WebLinkAbout487950 MAC-BESTOS INC - INSURANCE CERTIFICATEACORD. CERTIFICATE OF LIABILITY INSURANCE DATE 05/3 1/2011 Y) M/s/3ou PRODUCER 1-303-793-3388 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Associates Insurance Group ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 8400 E. Prentice Avenue ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Suite 300 Greenwood Village, CO 80111 FRED BAILEY INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A: PINNACOL ASSUR 41190 MAC-BESTOS, INC. INSURER B: 1235 DELAWARE STREET INSURER C: INSURER D DENVER, CO 80204 INSURER E: C(1V FRAGFS, 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSRADD' LTp INSR TYPE OF INSURANCE POLICYNUMBER POLICYEFFECTIVE DATE MMDO POLICYEXPIRATION DATE(MMIDDI LIMITS GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY CLAIMS MADE F71 OCCUR EACH OCCURRENCE $ DAMAGETORENTED PREMISES Ea occurence $ MED EXP(Any one person) $ PERSONAL &ADV INJURY $ GENERALAGGREGATE $ GENT AGGREGATE LIMIT APPLIES PER: POLICY PEO F7 LOG PRODUCTS-COMP/OPAGG $ AUTOMOBILE LIABILITY ANYAUTO ALLOWNEDAUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) $ BODILY INJURY (Peraccident) $ PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY ANYAUTO AUTOONLY-EAACCIDENT $ OTHERTHAN EA ACC AUTOONLV: AGG $ $ EXCESS/UMBRELA LIABILITY OCCUR F—ICLAIMS MADE DEDUCTIBLE RETENTION $ EACHOCCURRENCE $ AGGREGATE $ $ $ A WORKERS COMPENSATION AND EMPLOYERS'LIABILITY ANY PROPRIETOWPARTNEWEXECUTIVE OFFICER/MEMBER EXCLUDED? If yes, describe under SPECIAL PROVISIONS below 2109680 10/01/10 lo/O1/11 X TOO STATU I OTH- RYLIMITS ER EL EACH ACCIDENT 52,000,000 E.L. DISEASEEAEMPLOYEE $1, 000,000 E.L. DISEASEPOLICYLIMIT g1, 000, 000 OTHER DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT/ SPECIAL PROVISIONS ,,mm I Iri ,Ai C n V LUCM L,AIYL,CLLA I IUN SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION City of Fort Collins DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL Purchasing Department 215 N. Mason 2nd Floor IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. Fort Collins, CO 80524 AUTHORIZED REPRESENTATIVE / USA L ACORD 25 (2001/08) RSmothers O ACORD CORPORATION 1988 J^ - J IMPORTANT If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). 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). DISCLAIMER The Certificate of Insurance on the reverse side of this form does not constitute a contract between the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon. �' '`'� �® CERTIFICATE OF LIABILITY INSURANCE 5/31/2011 ' 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 endorsements . - PRODUCER CONTACT NAME: COWest Corporate Co West Insurance Group PO. BOX 910 PHONE N (303)688-9597(303)688-8858 _ ADDRESS info@COwest. com PRNou ER IDNA0011394 Castle Rock CO 80104 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A:Chartis (AIG) INSURER B:Nationwide Mutual 123787 Mac Bestos, Inc. INSURER C: 1235 Delaware St. INSURER D: INSURER E Denver CO 80204 INSURER F: COVERAGES CERTIFICATE NUMBER:10-11 MASTER REVISED 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 rypE OF INSURANCE ADDL SUBR POLICYNUMBER POLICY EFF MMIODIYYYY POLICY EXP MMIDDr/YYY LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR PROP1955634 e 9/1/2010 1. 9/1/2011 - EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED PREMISES Ea mumencel $ 100,000 MED EXP(Any one person) $ 10,000 PERSONAL S ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GENL AGGREGATE LIMIT APPLIES PER POLICY FX PRO- LOCJFCT ' PRODUCTS -COMPIOP AGO $ 2,000,000 - $ B AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS MIRED AUTOS NON -OWNED AUTOS CPeA7510622839 - 10/1/2010 30/1/2011 COMBINED SINGLE LIMIT (Ea accident) I $ .1, 000,000 X BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ Uninsured motorist combined $ 500,000 Medical payments $ 5,000 A X UMBRELLA LIAR I EXCESS LIAB X OCCUR CLAIMS -MADE PROU3112918 /1/2030 9/1/2011 -I EACH OCCURRENCE $ 3,000,000 AGGREGATE $ 3,000,000 DEDUCTIBLE RETENTION $ lO O00 S X S WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETORIPARTNERIEXECUTIVE OFFICERIMEMBER EXCLUDED? (Mandatory In NH) Use, describe under DESCRIPTION OF OPERATIONS below NIA WC STATU- OTH- E.L. EACH ACCIDENT $ E.L. DISEASE- FA EMPLOYE $ E.L. DISEASE- POLICY LIMIT $ A PROFESSIONAL LIABILITY POLLUTION & MOLD LIAR. ROP1955634 ,9/1/2010 9/1/2011 CONTRACTORS& $1,000,000 ASBESTOS ABATEMENT $2,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, N more space Is required) PROJECT: LINCOLN CENTER ASBESTOS ABATEMENT. CERTIFICATE HOLDER IS NAMED AS AN ADDITIONAL INSURED AS RESPECTS INSURED'S GENERAL LIABILITY COVERAGE - BLANKET ADDITIONAL INSURED ENDORSEMENT. GkfURRI 0 CITY OF FORT COLLINS ATTN: PURCHASING DEPARTMENT 215 N. MASON 2ND FLOOR FORT COLLINS, CO 80524 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 Meyers/AJM _f�� ©1988-2009 ACORD CORPORATION. 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