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HomeMy WebLinkAbout114078 FRONT RANGE FIRE PROTECTION INC - INSURANCE CERTIFICATE (2)9CORD.M CERTIFICATE OF LIABILITY INSURANCE CATE,MMYY) 06,0212011 PRODUCER PINNACOL ASSURANCE THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY 7501 E Lowry Blvd AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS Denver, CO 80230-7006 CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE NAIC# INSURED 'I 1Q FRONT RANGE FIRE PROTECTION INC 1wY�� V INSURER A: PINNACOL ASSURANCE 41190 INSURER e. 4007 S. LINCOLN AVE STE 460 INSURER L: LOVELAND, CO 80537 INsuaea D: INSURERE' COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDNG ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMMENT 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 ADD POLICY EFFECTIVE POLICYEXPIRATION LTR INSRD TYPE OF INSURANCE POLICYNUMBER DATE(MMIBD/19'VY) DATEIMMNDNYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE DAMAGE TO RENTED COMMERCIAL GENERAL LIABILITY LLAIMSMADE OCCUR PREMISES MEDEX Anyone Mr-n) PERSONAL& ADV INJURY GEN'L AGGREGATE LIMIT APPLIERS PER: GENERAL AGGREGATE PRODUCTS -COMPIOP AGG POLICY 5 PROJECT TOO AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT ANY AUTO (Ea Accdenl) BODILY INJURY ALL OWNED AUTOS SCHEDULED AUTOS )Per person) BODILY INJURY MIREDAUTOS NON OWNED AUTOS Pereccidenl) PROPERTY DAMAGE (Per occdenl) GARAGE LIABILITY AUTO ONLY EA ACCIDENT OTHER THAN EAACC ANY AUTO AUTO ONLY: AG EXCESSNMBRELLA LIABILITY OCCUR CLAIMS MADE EACH OCCURRENCE AGGREGATE DEDUCTIBLE RETENTION $ WORKERS COMPENSATION AND WLSTATU- OTHER A EMPLOYER'S LIABILITY ANY PROPRIETORIPARTNER)EXECUTIVE OFFICERIMEMBER EXCLUDED' 1651212 06101/2011 06/01/2012 ORY LIMITS E.L EACH ACCIDENT $500.000 EL DISEASEEAEMPLOYEE 1 $500.000 If yee, pluneo4oecnLennUer SPECIAL PROVISIONS OHl.w E.LDISEASE-POLICY LIMIT $500000 OTHER DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLE SIEXC LESIONS ADDED BY ENDORSE MEWISPECIAL PROVISIONS ALL LOCATIONS / ALL OPERATIONS CERTIFICATE HOLDER CANCELLATION 1314296 City of Fort Collins SHOULD ANY OFTHE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO PO Box 580 MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE Fort Collins CO 80522 LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE John ein ACORD 25(2001/08) to Underwriter ACORD CORPORATION 1988 OP ID: RK `AEMM 1oRo CERTIFICATE OF LIABILITY INSURANCE DAT06101111 rvl 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 endorsement(S). PRODUCER 724-832-9658 S&T Evergreen Insurance, LLC 701 East P ittsburgh St 724-832-9661 Greensburg, PA 15601 Kathy Koons CONTACT PHONE FAX AACNo, Eztf (AIC _No): ADDRESS: PRODUCER FRONT-2 CUSTOMER ID #: INSURERS) AFFORDING COVERAGE NAIC # INSURED Front Range Fire Protection INSURER A: Everest Indemnity Insurance Co 10851 INSURER B: Everest National Ins Co Inc 4007 S Lincoln Ave, Ste 460 Loveland, CO 80537 INSURER C - 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 LTRINS TYPE OF INSURANCE ADD UBR POLICY NUMBER MM/DDPLICYIYYYY MM/DO/YYYY LIMITS A GENERAL LIABILITY X COMMERCIAL GENERALLIABILITY CLAIMS -MADE FxI OCCUR 51GLOO1672111 COV IS INCLUDED IN THE 06/01111 06/01/12 EACH OCCURRENCE $ 1,000,00 DAMA T R NT PREMISES Ea occurrence $ 50,00 MED EXP (Any one person) $ 5,00 PERSONAL &ACV INJURY $ 1,000,00 X Errors & Ommissio GENERALAGGREGATE $ 2,000,00 GENL AGGREGATE LIMIT APPLIES PER POLICYFX1 PRO- F LOC PRODUCTS - COMPIOP AGG $ 2,000,00 $ B AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS MIRED AUTOS NON -OWNED AUTOS 51CA000095111 06/01111 06101112 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,00 X BODILY INJURY (Per person) IS BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ $ $ A - UMBRELLA LIAR EXCESS LIAB X OCCUR CLAIMS -MADE 51 CC0005350111 06/01A 1 06/01/12 EACH OCCURRENCE $ 5,000,00 X AGGREGATE $ 5,000,00 DEDUCTIBLE RETENTION $ 10,000 $ X Is WORKERS COMPENSATION ANDEMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in Ni If yes, describe under DESCRIPTION OF OPERATIONS below N / A WC STATU- OTH- T RY LIMIT R EL F1,CH ACCIDENT $ E.L. DISEASEEAEMPLOYEE $ E.L. DISEASE - POLICY LIMIT 1 $ (EXCESS LIAB COVERS OVER GL, AUTO,E L, LIAB DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space is required) Job Name: All Operations CITY-20 City of Fort Collins 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 (2009109) The ACORD name and logo are registered marks of ACORD ASSURANCE INSURED: FRONT RANGE FIRE PROTECTION INC 4007 S LINCOLN AVE STE 460 LOVELAND CO 80537 ENDORSEMENT: Waiver Of Subrogation 7501 E Lowry Blvd Denver, CO 80230-7006 Phone: (303) 361-4000 / (800) 873-7242 Fax: (303) 361-5000 / (888) 329-2251 NCCI #: WC000313 Policy #: 1651212 We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.) This agreement shall not operate directly or indirectly to benefit anyone not named in the Schedule. SCHEDULE City of Fort Collins PO Box 580 Fort Collins CO 80522 Effective Date: June 2, 2011 Expires on June 1, 2012 Pinnacol Assurance has issued this endorsement June 2, 2011. John Unrein Underwriter Pinuacol Assurance' 7501 E Lawry Blvd' Denver, CO 80230 Page l of PINNAWEB- External/EMP Record Onl 06102/201119:00:58 1651212 Updated: 02/01/2007 UW137