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Home My WebLink About103009 PORTER INDUSTRIES INC - INSURANCE CERTIFICATE (27)Client#: 14405 PORIN ACORD.. CERTIFICATE OF LIABILITY INSURANCE F DATE(MM/DD/YYYY) O6/13/2011 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 endorsement(s). PRODUCER CONTACT NAME: Kelly Beauvais Flood & Peterson Ins., Inc. PHONE A A/C No Eat : 970 266-7121 uc, No : 970 506-6846 P. O. Box 578 - Kell Beauvais@f Lnsurance.com ADDRESS: Y• P Greeley, CO 80632 PHUUUUEK 970 356-0123 CUSTOMER ID INSURERS) AFFORDING COVERAGE NAIL I INSURED INSURER A: Travelers Insurance Company Porter Industries, Inc. 8 INSURER B: Pinnacol Assurance Porter Industries, Inc. dba Maid Clean 5202 Granite Street INSURER C: Loveland, CO 80538 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. LTIL TYPE OF INSURANCEMIL POLICY NUMBER POLICY XP MWDD/YYY LIMITS A GENERALUABILIrY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE N OCCUR P6308107CO30 7/01/2011 07/01/2012 EACH OCCURRENCE $1000000 PREMISES Ea occurrence $300DOB MED EXP(Any one person) $10,000 PERSONAL& ADV INJURY $1,000,000 GENERALAGGREGATE $2,000,000 GEN'L AGGREGATE POLICY LIMIT APPLIES PER: X FRO LOG F JECT PRODUCTS - COMP/OP AGG $2,000,000 $ A AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS 8108107CO30T 7/01/2011 07/01/2012 COMBINED SINGLE LIMIT (Ea accident) $1,000,000 BODILY INJURY (Par person) S BODILY INJURY(Peraccident) S 1XX PROPERTY DAMAGE (Per accitlent) S $ $ A X UMBRELLA LIAR EXCESS LIAR OCCUR CLAIMS -MADE SMCUP8107CO3 7/01/2011 - 07/01/201 EACH OCCURRENCE $2000000 AGGREGATE s2,000,000 DEDUCTIBLE RETENTION 10000 $ X $ B WORKERS COMPENSATION AND EMPLOYERS' UABIL" IN ANY PROPRIETOPJPARTNER/EXECUrIVEY OFFICEWMEMBER EXCLUDED? (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below NIA 4038253 7/01/2011 07/01/2012 X WC STATu- OTH- EF E.L. EACH ACCIDENT $1 00O 000 EL DISEASEEAEMPLOYEE $1,DOO,DOD E.L DISEASE - POLICY LIMIT $1 OOODOO DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD lot, Addltiorml Remerka Schedule, If more apace is required) City of Fort Collins is listed as an Additional Insured as their interest may appear as respects General Liability. City of Fort Collins Custodial Services PO Box 580 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. #4.a4/1SL-L_ ACORD 25 (2009109) 1 Of 1 #S620541/M620538 @1988-2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD KLB Client#: 14405 PORIN ACORDn. CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DWYYYY) O6/13/2011 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(les) 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 CONTACT NAME: Kelly Beauvais Flood & Peterson Ins., Inc. PHONE y70 266-7121 970 506-6846 A/C No Est : A/C, No P. O. Box 578 ADDREss: Kelly.Beauvais@fpinsurance.com Greeley, CO 80632 PHUUUUbH 970 356-0123 CUSTOMER ID A: INSURER(S) AFFORDING COVERAGE NAICA INSURED INSURER A. Travelers Insurance Company Porter Industries, Inc.& INSURED B: Pinnacol Assurance Porter Industries, Inc. dba Maid Clean 5202 Granite Street INSURER C: Loveland, CO 80538 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 INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHIC CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TE EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. L TYPE OF INSURANCE ADDL NUB POLICY NUMBER MWDD/YFF MWDD/YYY LIMIT A GENERAL LIABILITY X COMMERCIAL GENERAL LIABIUTV 51OCCUR P6308107CO30 I 7/01/2011 07/01/201 EACH OCCURRENCE W PREMISES Ea occurrence)CLAIMS-MADE MEDEXP(Anyoneperson) PERSONAL& ADVINJURY GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY X PRO LOC PRODUCTS - COMP/OP AGG $2,000,000 $ A AUTOMOBILE LIABILITY ANYAUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS 8108107CO30T 7/01/2011 07/01/2012 COMBINED SINGLE LIMIT (Ea accident) $1.000.000 X BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) S X X $ 5 A 1( LlEXCESS I UMBRELLA LIAB LIAB OCCUR OLAIk15-MADE SIACUP8107CO3 7/01/2011 07/01/201 EACH OCCURRENCE $2000000 AGGREGATE $2 000OOO DEDUCTIBLE RETFNnoN 10000" $ X $ B WORKERS COMPENSATION ANDEMPLOYERS' LIABILRY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE — OFFICERIMEMBER EXCLUDED? (Mandator, In NH) If yes describe under DE SCRIPTION OF OPERATIONS below N/A 4038253 7/01/2011 07/01/201 X WC STAru- OR Y LIMITS E.L. EACH ACCIDENT $1,000,000 E.L. DISEASE - EA EMPLOYEE $1,000,000 E.L. DISEASE - POLICY LIMIT $1000000 DESCRIPTION OF OPERATIONS / LOCATIONS/ VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) City of Fort Collins Carpet Maintenance 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 ACORD 25 (2009109) 1 of 1 #S620746/M620538 01988-2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD KLB Client#: 14405 PORIN ACORDTM CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) O6113/2011 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 endorsement(s). PRODUCER IONTACT NAME: Kelly Beauvais Flood &Peterson ins., Inc. PHONE 970 266-7121 970 506-6846 A/C No EH: NC, No: P. O. Box 578 AODREss: Kelly.Beauvais@fpinsurance.com Greeley, CO 80632 PRODUCER 970 356-0123 CUSTOMER ID a: INSURER(S) AFFORDING COVERAGE NAIC INSURED INSURER A: Travelers Insurance Company Porter Industries, Inc. & INSURER B: Pinnacol Assurance Porter Industries, Inc. dba Maid Clean 5202 Granite Street INSURER C Loveland, CO 80538 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. 1.111— TYPE OF INSURANCE POLICY NUMBER MW�O EFF N�YOn%P LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CIAIMS-MADE 19 OCCUR P6308107CO30 7/01/2011 07/01/2012 EACH OCCURRENCE $1000000 DAMAGE PREMISES Ea occurrence $300OOO MED EXP (Any one person) $10,000 PERSONAL& ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY X PRO LOG PRODUCTS - COMP/OP AGG $2,000,000 $ A AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS 8108107CO30T 7/01/2011 07/01/2012 COMBINED SINGLE LIMIT (Ea accident) $1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accitlent) S 1XX PROPERTY DAMAGE (Per accitlent) $ S A X UMBRELLA LIAB E%CESS LIAR OCCUR CLAIMS -MADE SMCUP8107CO3 7/01/2011 07/01/2012 EACH OCCURRENCE $2000000 AGGREGATE s2,000,000 DEDUCTIBLE RETENTION 10000 $ X S B WORKERS COMPENSATION AND EMPLOYERS' LIABILITYTORY[ANY PROPRIETOWPARTNER/EXECUnVE :] OFFICER/MEMBER EXCLUDED? (Mandatory In NH) II ee, dsoon be under DES CRIPTIONOFOPERATIONSbelO WA 4038253 7/01/2011 07/01/2012 X I WE STATU. I orH- E.L. EACH ACCIDENT $1,000,000 E.L. DISEASE - EA EMPLOYEE $1,000,000 E.L. DISEASEPOLICYLIMIT $1000000 DESCRIPTION OF OPERATIONS / LOCATIONS/ VEHICLES (Aaach ACORD 101, Addiflorul Remains Schedule, B more apace is required) City of Fort Collins is listed as an Additional Insured as their interest may appear as respects General Liability. City of Fort Collins Northside PO Box 580 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 ACORD 25 (2009109) 1 of 1 #S620553/M620538 ®1988-2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD KLB Client#: 14405 PORIN ACORD CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/1'YYY) O6/13/2011 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(les) 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 CONTACT NAME: Kelly Beauvais Flood &Peterson Ins., Inc. PHONE g70 266-7121FAX A/c No Ert : Am. Nc : 970 506-6846 P. O. Box 578 ADDRESS: Kelly.Beauvais@fpinsurance.com Greeley, CO 80632 PRODUCER 970 356-0123 CUSTOMER ID #: INSURER(S) AFFORDING COVERAGE NAIC # INSURED INSURER A: Travelers Insurance Company Porter Industries, Inc. & INSURER B: Pinnacol Assurance Porter Industries, Inc. dba Maid Clean 5202 Granite Street INSURER : Loveland, CO 80538 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, LTIL TYPE OF INSURANCE POLICY NUMBER MWDD/YFF MWDO/VYP LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABIUTY CLAIMSMADE51OCCUR P6308107CO30 7/01/2011 07/01/2012 EACH OCCURRENCE $1000000 UAMAUE PREMISES Eacacurrence s3000OO MED EXP (Any one person) $10,000 PERSONAL& ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POUCV X PRo- LOG PRODUCTS - COMP/OP AGO 52,000,000 $ A AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS AUTOS 8108107CO30T 7/01/2011 07/01/201 COMBINED SINGLE LIMN (Ea accident) $l000000 BODILY INJURY (Par person) S BODILY INJURY (Per accident) $ 1XX PROPERTY DAMAGE (Per accident)NON-OWNED $ A X UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS -MADE SMCUP8107CO3 7/01/2011 07/01/2012 EACH OCCURRENCE s2000000 AGGREGATE $2 OOO OOO DEDUCTIBLE RETENTION 10000 $ X S B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y/N ANY PROPRIETORIPARTNER/EXEGUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory In NH) It yes, describe under DESCRIPTION OF OPERATIONS below WA 4038253 7/01/2011 07/01/2012 X lwGM, I IOTH- E.L. EACH ACCIDENT $1,000 000 E.L. DISEASE- EA EMPLOYEE $1,000,000 EL.DISEASE -POLICY LIMIT $1000000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (At1ac11 ACORD 101, Additional Remains Schedule, N more apace Is required) City of Fort Collins is listed as an Additional Insured as their interest may appear as respects General Liability. City of Fort Collins YAC SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE PO Box 580 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Fort Collins, CO 80524 AUTHORIZED REPRESENTATIVE Q6 ftu.r�s� 01988-2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009/09) 1 of 1 The ACORD name and logo are registered marks of ACORD #S620694/M620538 KLB