HomeMy WebLinkAbout133071 BIO KLEAN WORLD ENVIRONMENTAL INC - INSURANCE CERTIFICATE7/27/2011 9:59 AM FROM: JCB TO: 9702216707 PAGE: 002 OF 002
ACORO® CERTIFICATE OF LIABILITY INSURANCE
IDATE
07/27/2011
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 pollcy(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 endorsements .
PRODUCER
CONTACT
NAME:
JOHN C. BECKETT & ASSOCIATES, INC.
AHm"xu Ex: (970) 484-2805 (9701 ASA-xses
AA, nP):
220 Smith Street
ADDRESS tim@beckettins=ance.com
PRODUCER Bio Klean World Environmental, Inc.
CUSTOMER O 9.
Ft. Collins CO 80524-
INSURERS) AFFORDING COVERAGE
NAICi
INSURED
INSURER A :BURLINGTON INSURANCE CO
Bio Klean World Environmental, Inc.
INSURER B
145 West Swallow Road, Ste A2
INSURER C
INSURER 0
NSURER E
Fort Collins CO 80525-2500
INSURER F
COVERAGES CERTIFICATE NUMBER- RPVISInN NIIMRFR.
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 1MMICH 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.
PER
OOL
EVER
POLICY EFF
POLICY SAP
LTR
TYPE OF INSURANCE
NER
WVO
I POLICY NUMBER
eALDOnr n
IWNOOTTY1j
LASTS
A
GENERAL LABLm'
21OB522996
7/27/2011
7/27/2012
EACH OCCURRENCE
$ 1,000,000
X COMMERCIAL GENERAL LIABILITY
/ /
/ /
PREMISES Be Cocunence
$ 100,000
CLAIMS ADE �X OCCUR
/ /
/ /
MED ENP (Any one person)
$ 5,000
PERSONAL B ADV INJURY
$ 1,000,000
GENERAL AGGREGATE
$ 2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
PRODUCTS - COMPIOP AGG
$ 2,000,000
/ /
/ /
X POLICY PRO- LOC
/ /
/ /
EBLIA
$
AUTOWOWLE
LUSLRY
O COVERAGE
/ /
/ /
COMBINED SINGLE LMIT
(Ea accident
$
ANY AUTO
BODILY INJURY (Per person)
$
ALL04VMEDAUTOS
/ /
/ /
BODILY NJURY(Per ax'Idem)
$
/ /
/ /
SCHEDULED AUTOS
Y DAMAGE
$
HIREDAJTOS
/ /
/ /
(Perr�tilters)
NOWOMED AUTOS
UNBRELLA uAB
OCCUR
0 COVERAGE
/ /
/ /
EACH OCCURRENCE
S
EXCESS Lee
CLAIMSlAADE
/ /
/ /
AGGREGATE
DEDUCTIBLE
$
/ /
/ /
RETENTION S
/ /
/ /
$
WORKERS COMPENSATON
O COVERAGE
/ /
/ /
V•C STATD- OTH-
AND EMPLOYERS' LABILITY YIN
/ /
/ /
ANY FROPRIETORNARTNER�E%ECUI'vE
.
E.LEACH ACCIDENT
OFF ICERMEMBER E%CWDE09 El
N/A
/ /
/ /
(Mandatory In NH)
E.L. DISEASE - EA EMPLOYEE
$
If,, desc,belndar
/ /
/ /
DESCRIPTION OF OPERATIONS below
EL DISEASE -POLICY LIMIT
$
-
O COVERAGE
DESCIUMOR OF MERRIONS I LOCATIONS / VEHICLES NOZM ACORD 1M, A.. R—.. EaLFL4 I men NMK. N ,puolt
l.Ml'Ib CLLN I I V tl
( ) - (970) 221-6707
CITY OF FORT COLLINS
AINIMISTRATIVE SERVICES
P O BOX 580
FORT COLLINS CO 80522-0580
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
AUMORI REPRESENTATNE
ACORD 25 (20091091
SGRR_9nne ArnRn f ORon RannN All drihfe menrvnd
INS025 (200909) The ACORD name and logo are registered marks of ACORD