HomeMy WebLinkAbout491442 MIX PAINTS - INSURANCE CERTIFICATET.T
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CERTIFICATE OF LIABILITY INSURANCE II022
DATEIMMIDDIYYYYI
08-18-2011
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 AD DIT10NAL INSURED, the policy(ies) must be endorsed. If SUBROGATIONIS 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 endorsementls).
PRODUCER
PEAK 360 INC/PHS
345370 P:(866)467-8730 F:(877)905-0457
PO BOX 33015
SAN ANTONIO TX 78265,
CONTACT
NAME:
P.00NNO EVL: (866)467-8730 INC, Na: (877)905-045
E-MAIL
AD DRESS:
ODUCER
C STOMERID p:
INSURERS) AFFORDING COVERAGE
NAIC p
INSURED
INSURERA: Sentinel IRS CO LTD
INSURERS: Twin City Fire Ins Co
MIX PAINTS INC
5218 E COLFAX AVE
INSURERC:
DENVER CO 80220
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,
INS.
LT.
TYPE OF INSURANCE
/NSF IDOL
UOR
POLICY NUMBER
LILY EFFPOLICY/EXP
(MOLICY EFF
(XP
LIMITS
A
GENERAL LIABILITY
MERCIAL GENERAL UABIUTY
COMCLAIMS-MADE OCCUR
X General Liab
34 SBM PJ6361
05/18/2011
04/22/2012
EACH OCCURRENCE
a 1, 000000
PREMISES I°Eaoccurrencel
5 1 r 000, 000
MED EXP (Any one person)
s 10, 000
PERSONAL & ADV INJURY
s 1,000, 000
I
GENERAL AGGREGATE
s 2, 000, 000
'L AGGREEEEGGGGPAAPTTTT
POUCYPRO-
UNIT A S PER:
LOC
PRODUCTS - COMPIOP AGG
$ 2, 000, 000
s
AUTOMOBILE
LIABILITY
ANYAUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON OWNED AUTOS
COMBINED SINGLE UNIT
(Ea accident)
s
BODILY INJURY (Per person)
s
BODILY INJURY (Per accident)
$
PROPERTY DAMAGE
IPer accident)
$
$
s
UMBRELLA LIAB
EXCESS LIAR
OCCUR
CLAIMS MADE
EACH OCCURRENCE
a
AGGREGATE
$
DEDUCTIBLE
RETENTION 9
$
s
B
WORKERS COMPENSATION
ANDEMPLOYERS'LIABILITV YIN
ANY PRO PRI ETORIPARTNERIEX ECUTIVE
(Mandatory b, NHI EXCLUDED/ ❑
ldao
If yes, describe under
DESCRIPTION OF OPERATIONS below
N/A
34 WEC VY5962
04/22/2011
04/22/2012
- OTH-
X FT
TORYUMI TS ER
E.L. EACH ACCIDENT
$SOO, O00
E.L. DISEASEEAEMPLOYEE
s500, 000
E.L. DISEASE POLICY LIMIT
s500,000
DESCRIPTION OF OPERA TIONSILOCATIONSI VEMCLES Utfach ACORD 107, AOCQunefRema nr SchaEub, H mom.tpaca b rpuhdl
Those usual to the Insured's Operations.
CITY OF FORT COLLINS
NATURAL RESOURCES DEPARTMENT
215 N MASON ST
FORT COLLINS. CO 80524
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED
BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE
AUTHORIZED REPRESENTATIVE
D 1988-2009 ACORD CORPORATION. All rights reserved.
ACORD 25 12009/09) The ACORD name and logo are registered marks of ACORD