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HomeMy WebLinkAboutS & S SANITATION INC - INSURANCE CERTIFICATEOP ID: KH ,a►�oRo..... - CERTIFICATE OF LIABILITY INSURANCE °A'06110/1YVYY) `_- 10/11 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: 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 970-635.9400 PFS Insurance Group -JT 4848 Thompson Pkwy, Ste 200 Johnstown, CO 80534 Tad Borrett CONTACT -NMLEg70-635-9401 PHONE FAX AIC No Ext : AIC No), E-MAIL ADDRESS: PRODUCER S&SSA-1 CUSTOMER ID e: INSURERS AFFORDING COVERAGE NAIL It INSURED S & S Sanitation, Inc. 559 S. St. Louis Loveland, CO 80539 INSURER A: United Fire & Casualty 13021 INSURER B: Pinnacol Assurance 41190 INSURER C INSURER D: INSURER E INSURER F COVFRAGFS 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 INSURANCEAFFORDED 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 LTRINSg TYPE OF INSURANCE ADDL SUB Mn pOLICV NUMBER MMIODPOLICYIYYYY EFF MMIODIYYYY LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE FXI OCCUR 60033560 09/11/10 09111111 EACH OCCURRENCE $ 1,000,00 PREMISES Ea occurrence $ 100,00 MED EXP (Any one person) $ 5,00 PERSONAL B ADV INJURY $ 1,000,00 GENERAL AGGREGATE $ 2,000,00 GEN'L AGGREGATE LIMIT APPLIES PER. POLICY PRO LOC PRODUCTS-COMPIOP AGO $ 2,000,00 $ A AUTOMOBILE LIABILITY ANYAUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON-OWNEDAUTOS 60033560 09/11/10 09/11/11 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,00 BODILY INJURY (Per person) $ - BODILY INJURY (Per accident) $ X PROPERTY DAMAGE (Per accident) $ X X $ A UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE 60033560 09111110 09/11111 EACH OCCURRENCE $ 1,000,00 AGGREGATE $ 1,000,00 DEDUCTIBLE RETENTION $ 10 000 $ X $ B WORKERS COMPENSATION _ _._ AND EMPLOYERS' LIABILITY ANY PROPRIETORIPARTNERIEXECUTIVE Y1 OFFICER/MEMBER EXCLUDED? (Mandatory In NH) If yas, describe under DESCRIPTION OF OPERATIONS below __ NIA — — --- — 2160642 07101111 07/01/12 WC STATU- OTH- X IMIT X _ER E.L. EACH ACCIDENT $ 500,00 E.L. DISEASE- EA EMPLOYEE $ 500,00 E.L. DISEASE- POLICY LIMIT $ 500,00 N/A DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ANsch ACORD 101, AddlUonal Remarks Schedule, If more space is required) All Operations - All Locations CERTIFICATE HOLDER CANCELLATION CITYOFF SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of Fort Collins Treasury Division Box 281 N College Ave AUTHORIZED REPRESENTATIVE Ft Collins, COC80522-0580 Ft ©1988.2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009109) The ACORD name and logo are registered marks of ACORD