HomeMy WebLinkAbout111347 HAMILTON LINEN SUPPLY - INSURANCE CERTIFICATE (3)OP ID: EQ
At1>✓^O^ _ _CERTIFICATE -OF LIABILITY INSURANCE ,
_.
DATE010411/YYV)
1041„
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:'rlf the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject -to-:
,+the terms and conditions oLthe policy,lcertain policies mayrequire an endorsement A statement on this Certificate does not confer rights to the'"
certificate holder in lieu of such endorsements . I '
'PRODUCER _.-.__ -- B16�74-3535
CONTACT _
NAME
Hays Companies of Kansas City 816-842-5795
920 Main Street, Suite 2100
Kansas City, MO 64105
PHONE FAX
AIC No Ex[), AX:, No):
EMAIL
ADDRESS
:PRODUCER
CUSTOMER ID t FAULT-2
INSURER(S) AFFORDING COVERAGE
NAIC
INSURED Hamilton Laundry Company
INSURERA: Hartford Fire Insurance Co.
19682
Faultless Laundry Company Inc.
INSURERS: Twin City Fire Insurance Co.
29459
1480 E. 61 st Street
INSURERC: St Paul Fire & Marine Ins Co
24767
Denver, CC 80216
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.
INSR
LTR
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFF
MMDD/tYYY
POLICY EXP
MMDOfYYYY
LIMITS
GENERALLIABILITY -
- -
EACH OCCURRENCE
i 1,000,000
At{7,X7
.COMMERCIAL. GENERAL LIABILITY
•.l LLAIMSMADE'a OCCUR'
:X
I •37UENOC1701,
T ,. ,,,
!•„ r ,' :;
03101/11
03101112
PREMISES Ep oa enw'
$ 300,000
MED EXP Any one person)
$ �S,000
n
v;; ,, :'.,• t 7. .. •: _:. '.,f('"
_
,•.: .. ,� ..
- .-_.
_ -..
PERSONAL 3ADV IN AIRY_.
g"" 1',000;000
1 '^' -
GENFRN. AGGREGATE .M.,
$ 1, ,.,2,000,000
.... '". " ..
. •
GEN'L AGGREGATE LIMITPPPLIES PER'.
PRODUCTS-COMP/OP'AGr
$,-'2,000;000
1
I
POLICY ..'. PRO- _ LOC
IsPrT
A
AUTOMOBILE
X
LIABILITY
ANY AUTO
-
37UENOC1702
03/01/11
03/01/12
COMBINED SINGLE LIMIT
(Ea acadsm)
$ 1,000,00
N BODILY JURY(Per person)
$
ALL OWNEDAUTOS
BODILY NJJRY (Per acadenll
;
X
SCHEDULED ALTOS
HIREDAUTOS
PROPERTY OHMAGE
IPerecod.rr
$
$
X
NON-OWNEDAUTOS
Comp Dad: $1000
g
UMBRELLA LAB
X 'CUR
EACH OCCURRENCE
00
; 1,0, 000
AGrIRGA,E
,; 1,1100,011
C
Dxcrss LlAD
- L:aais-mADe
QK06001132
03I0111,
03101112
UEDUCIIBLE
;
$
X
RETENTION $ 10,OOo
B
WOPo(ERS COMPENSATION
ANDEMPLOYERS'LIABILITY
ANYPPOPRIEIORIPARTNERIEXECUTIVE YIN
37WEOC1700
03,01111
03/011
X WC STATU- VTH-
TOR, LIMITS ER
EL. EACH ACCIDENT
$ 500,00
OFFICERINEMBER EXCLUDED? a
(Mand story In NH)
N I A
EL DISEASE-EAEMPLOYEE
$ 500,00
II yes, desanDe udder
DESCRIPTIONOFOPERATIONSOelon
E.L. DISEASE-POLICYLIMIT
$ 500,00
DESCRIPTION OF OPERATIONS I LOCATIONS / VEHCLES (All ACORD 101, Addltlonal Rema Ma Schedule, If mom space is required)
As respects General Liability, City of Fort Collins Is Included as
Additional Insured as required by written contract.
CITYFTC
City of Fort Collins
PO Box 580
Ft. 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 REPRESENJT�ATIVEivIi � �
.
Pn PATInN All rinhho red —A
ACORD 25 (2009109) The ACORD name and logo are registered marks of ACORD