HomeMy WebLinkAbout132191 MOUNTAIN PARKING EQUIPMENT - INSURANCE CERTIFICATE (9)ACORD. CERTIFICATE OF LIABILITY INSURANCE os/a7 aopii�)
PRODUCER 1-303-793-3388 1 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
iates Insurance Group
E. Prentice Avenue
300
wood Village, CO 80111
Sullivan
r Corporation dbe )A�
sin Parking Equipment i I/ L 19
S. Cherokee St.
CO 80223
CH4Y1 �•1cTH�-9
INSURERS AFFORDING COVERAGE
INSURER A:' VSLERS CAS INS CO OF AMER
INSURERS PINNACOL ASSUR
THE
NAIC p
19046
41190
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,
INSR
LTR
ADO'IJ
POUCYNUMBER
POLICY EFFECTIVE
p M
POLICY EXPIRATION
LIMITS
A
X
GENERAL LABILITY
6608759X948
06/01/11
06/01/12
EACHOCCURRENCE
$1,000,000
X COMMERCIAL GENERAL LIABILITY
CIAIMSMADE aOCCUR
OAMAGETOR EN
PREMISES Eaoccurence
$ 100, 000
MED EXP(Any one person)
$5,000
PERSONAL B ADV INJURY
$1,000,000
GENERALAGGREGATE
$2,000,000
GENL AGGREGATE LIMIT APPLIES PER:
PRODUCTS-COMP/OP AGG
$2,000,000
PRO LOG
X I POLICY I JECT 1-7
A
AUTOMOBILE
X
LIABILITY
ANY AUTO
BA8769X536
06/01/11
06/01/12
COMBINED SINGLE LIMIT
(Ea auitlenl)
S1,000,000
BODILY INJURY
(Per parson)
$
ALLOWNEDAUTOS
SCHEDULED AUTOS
X
BODILY INJURY
(Peraccid nt)
$
HIREDAUTOS
NON-OWNEDAUTOS
X
PROPERTY DAMAGE
(PeramiG nt)
$
GARAGE LIABILITY
AUTO ONLY -EA ACCIDENT
S
OTHERTHAN EA ACC
I S
AM AUTO
I $
AUTOONLY: AGG
A
EXCESMMBRELLALIABILDY
CUPB772X252
06/01/11
06/01/12
EACH OCCURRENCE
I 55,000,000
X OCCUR CLAIMSMADE
AGGREGATE
$ 5,000,000
$
S
DEDUCTIBLE
$
RETENTION $
B
WORKERS COMPENSATION AND
4011572
06/01/11
06/01/11
X WCSTATIMIU- E ORY LTS R
TY
ANPLOYERIETORJ ART
ANVCEWMEMBRIPARTNDED? UTIVE
E.L. EACH ACCIDENT
$1,000,000
E.L. DISEASE - EA EMPLOYEE
$1,000,000
OFFICER/MEMBER EXCLUDED'!
It Yee, tlescribe untler
SPECIAL PROVISIONS Wow
ELDISEASE-POLICY LIMIT
$1.000,000
OTHER
A
Installation Floater
6608759X948
06/01/11
06/OffF
One Location 90,000
DESCRIPTION OF OPERATIONS/ LOCATIONS/ VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
If required by written agreement, City of Fort Collins is named Additional Insured as respects General Liability.
•,CmI1fR,X I C ITULUCIT UANGGLLA I KJN-EX4ept lU Day notice rOr non-payment
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 30 DAYS WRITTEN
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
215 N. Maaon IMPOSE NO OBLIGATION OR LABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
REPRESENTATIVES.
Fort Collins, CO 80524 AUTHORIZED REPRESENTATIVE
USA 1./...LU,•�
ACORD 25(2001/08) ESmothera �-' ® ACORD CORPORATION 1988
21430114
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.
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