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Home My WebLink About480231 SECOND WAVE AUTOMOTIVE CARE INC - INSURANCE CERTIFICATECERTIFICATE OF LIABILITY INSURANCE _ DATE 6/23/2011rY) 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 jAHicoNo Eat: (303) 688-9597 aC No: (303)668-8859 CO West Insurance Group PO BOX 910 EW IL ADDRESS: info@contest. corn PRODUCERCUSTOMER,poA0074644 INSURER(S) AFFORDING COVERAGE NAICN Castle Rock CO 80104 INSURED INSURERA:COlorado Casualty Insurance Co 20621 INSURER B:Peerless Indemnity 18333 INSURER C:Pinnacol Assurance 41190 Second Wave Automotive Care, LLC 1921 S Alma School Road INSURER D: Ste 110 INSURER E Mesa AZ 85210 INSURER F: COVERAGES CERTIFICATE NUMBER. -Master 11/12 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 TYPE OF INSURANCE ADbl SUER POLICY NUMBER MM/DDY/YYYY EFF MM/DD/YYYY LIMITS LTRINSR A GENERALLIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE 1XI OCCUR BP0706320 7/28/2011 7/28/2012 EACH OCCURRENCE $ 1,000,000 AMA ET RENTED PREMISES Ea occurrence $ 100,000 MED EXP(Any one Person) $ .15,000 PERSONAL B ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE X POLICY LIMIT APPLIES PER: PRO LOC PRODUCTS -COMP/OP AGG $ 2,000,000 $ A AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON-O MED AUTOS ICBP8706320 /28/2011 7/28/2012 COMBINED SINGLE LIMB (Ea accident) - $ 1,000,000 BODILY INJURY per person) $ BODILY INJURY per accident) $ PROPERTY DAMAGE (Per accdent) $ X X $ B X UMBRELLA LIAB EXCESS LIAB OCCUR Hi CLAIMS -MADE 1 U8706520 /28/2011 /28/2012 EACH OCCURRENCE $ 1,000,000 AGGREGATE $ 1,000,000 DEDUCTIBLE RETENTION $ 10 000 $ I X $ L+ WORKERS COMPENSATION AND EMPLOYERS' LIABILITYTRY ANY PROPRIETORIPART1E XECUTIVE Y/N OFFICER/MEMBER EXCLUDED? in NH)E.L. If yes, describe under DESCRIPTION OF OPERATIONS beIvx N/A 129995 /1/2011 F3/1/2012(Mandatory x Vvt STATU- OTH- LIM E.L. EACH ACCIDENT $ 100,000 DISEASE - EA EMPLOYEE $ 100,000 E.L. DISEASE -POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, 8 more space is required) 1�ALaJgUgk1 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 ACORD 25 (2009109) Madron/SLB se,.&� M. Ma-� ©1988-2009 ACORD CORPORATION. All rights reserved I N5UZD (200909) I ne Awrcu name and logo are registered marks oT ACUItU