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HomeMy WebLinkAbout487950 MAC BESTOS INC - INSURANCE CERTIFICATE (2)``II �® CERTIFICATE OF LIABILITY INSURANCE 9/29/201n1 Y) 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 ' Co West Insurance Group PO Box 910 PHONN E.C.(303)688-9597 FAIIC Noc(30e)6ee-8858 EJAAIL ADDRESS: info@cowest.com PRODUCER 00011394 -OUSTOMER.IB U. INSURERS AFFORDING COVERAGE NAICM Castle Rock CO 80104 INSURED INSURER A C$artis (AIG) INSURERB:Auto Owners 1$9$$ Mac Best Os, Inc. INSURER C: 1235 Delaware St. INSURER D: INSURER E Denver CO 80204 INSURER F: COVERAGES CERTIFICATE NUMBER:11-12 MASTER 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 SUBR WVDPOLICY NUMBER POLICY EFF MM/DDIYYYY POLICY EXP MMIDDIYYYYI I LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE TOCCUR ROP1955634 9/1/2011 9/1/2012 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED PREMISES Ea occurrence $ 100,000 MED EXP(My one person) $ 10,000 PERSONAL& ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE X POLICY LIMIT APPLIES PER: F--] PRO n LOG PRODUCTS - COMPIOP AGG $ 2,000,000 $ B AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIREDAUTOS NON-0WNED AUTOS ' 48963049 10/1/2011 10/1/2012 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 X BODILY INJURY Per person) $ BODILY INJURY Per accident) $ PROPERTY DAMAGE (Per accident) $ $ A X UMBRELLA LIAR EXCESS LIAB OCCUR CLAIMS -MADE ROV3112918 ;9/1/2011 ,9/1/2012 EACH OCCURRENCE $ 3,000,000 AGGREGATE $ 31000,000 DEDUCTIBLE RETENTION $ 10,000 $ X $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y I N ANY PROPRIETORIPARTNEWEXECUTIVE OFFICERIMEMBER EXCLUDED? (MarMatory In NH) If yes, descnW under DESCRIPTION OF OPERATIONS below NIA WC STATU- DTH- E.L. EACH ACCIDENT $ E.L. DISEASE- EA EMPLOYEE $ E.L. DISEASE- POLICY LIMIT $ A PROFESSIONAL LIABILITY POLLUTION & MOLD LIAB. I PROP1955634 9/1/2011 9/1/2012 CONTRACTORS& $1,000,000 ASBESTOS ABATEMENT $2, 000, 000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, N more space is required) PROJECT: LINCOLN CENTER ASBESTOS ABATEMENT. CERTIFICATE HOLDER IS NAMED AS AN ADDITIONAL INSURED AS RESPECTS INSURED'S GENERAL LIABILITY COVERAGE - BLANKET ADDITIONAL INSURED ENDORSEMENT. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN CITY OF FORT COLLINS ACCORDANCE WITH THE POLICY PROVISIONS. ATTN: PURCHASING DEPARTMENT 215 N. MASON AUTHORIZED REPRESENTATIVE 2ND FLOOR FORT COLLINS, CO 80524 Craig Meyers/Aim ACORD 25 (2009109) ©1988-2009 ACORD CORPORATION. All rights reserved. INS025 (200909) The ACORD name and logo are registered marks of ACORD