No preview available
HomeMy WebLinkAbout104133 FORT COLLINS MONUMENT & STONE - INSURANCE CERTIFICATEA t4`'""" CERTIFICATE OF LIABILITY INSURANCE F DATE(MMIDD/YYYY) 07/06/2011 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: Ewing -Leavitt Insurance Agency PNHONH E,t:970.679.7333 FAX Na)_866.456.4265 EMAIL ADDRESS: 4025 St. Cloud Dr. Suite 100 PRODUCER 00005631 CUSTOMER ID d: INSURERIS) AFFORDING COVERAGE NAIC It Loveland, CO 80538 INSURED INSURER A: Cincinnati Insurance Co Fort Collins Monument & Stone INSURER B: 824 E. Lincoln Ave INSURER C: Ft Collins, CO 80524 INSURER D: INSURER E INSURER F : COVERAGES CERTIFICATE NUMBER: 11/12 Cinci Refill 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 LTR TYPE OF INSURANCE ADDL INSR SUER VIVID POLICY NUMBER POLICY EFF MMIDD/YYYY POLICY E%P MMIDD/YYYY LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE M OCCUR X Blanket Add ' 1 Ins CPP108408507124/2011 07/24/2012 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED PREMISES Ea occurrence $ SOO, OOO MED EXP (Any one person) $ 10,000 PERSONAL & ADV INJURY $ 1,000,000 X Blanket Wvr of Sub GENERAL AGGREGATE $ 2,000,00 GEN'L AGGREGATE LIMIT APPLIES PER. X POLICY PRO LOC ECT PRODUCTS - COMPIOP AGG $ 2,000,00 $ A AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON-OWNEDAUTOS CPPI084085 07/24/2011 07/24/2012 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 X BODILY INJURY (Per person) $ BODILY INJURY (Par accident) $ PROPERTY DAMAGE (Per accident) $ X X $ A X UMBRELLA LIAR EXCESS LIAR X OCCUR CLAIMS -MADE � CPP1084091 07/24/2011 07/24/2012 EACH OCCURRENCE $ 1,000,00 AGGREGATE $ HXDEDUCTIBLE RETENTION $ 10, OD $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY y I N ANY PROPRIETORIPARTNE'EXECUTIVE❑ OFFICEWMEMBER EXCLUDED? (Mandatory in NH) If yes describe under DESCRIPTION OF OPERATIONS below NIA I WC STATU I OTH- TORY LIMITS I ER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE -POLICY LIMIT $ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD tall, Additional Remarks Schedule, if more space Is required) l:tK 111-1i I It HUL-ULK CANCELLATION 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 Attn: Alyce Carpenter AUTHORED REPRESENTATIVE P. 0. Box 580 Forst Collins, CO 80522 Dianne Littlefield/DEL © 1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009109) The ACORD name and logo are registered marks of ACORD