HomeMy WebLinkAboutWYCOLO SOLUTIONS LLC - INSURANCE CERTIFICATEUSAA INSURANCE AGENCY INC/PHS
PO BOX 33015
SAN ANTONIO TX, 78265
WYCOLO SOLUTIONS LLC
109 E 17TH ST STE 8
CHEYENNE, WY 82001
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ACORD 25 (2009/09)
CERTIFICATE OF LIABILITY INSURANCE
1DATE
05-2011
THIS CERTIFICATEIS 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 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 endorsement(s).
PRODUCER
CONTACT
NAME:
USAA INSURANCE AGENCY INC/PHS
HONE En: (868)292-1930 i e,Nel: (877)905-045
812846 P:(888)242-1430 F:(877)905-0457
E-MAIL
PO BOX 33015
PRODUCER
SAN ANTONIO TX 78265
CUSTOMERID N:
INSURER(S) AFFORDING COVERAGE
NAIL N
AVSMD
INSURER A: Sentinel Tns CO LTD
11000
INSURER B:
WYCOLO SOLUTIONS LLC
109 E 17TH ST STE 8
INSURER C:
CHEYENNE, WY 82001
INSURER D:
INSURER E
INSURER F:
rnvFRAr:FC r.FRTIFIC..ATF NUMRFR: 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.
LTq
TYPE OF MSURANCE
I R
P'OLA:Y NUMBER
Y EFF
(MM�ANNY1'YY)
LACY E"
(MMA]O/YYYVI
[MIS
A
GENERAL
WIBIUTY
COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE IJ OCCUR
General Liab
65 SBM TB8424
10/04/2011
10/04/2012
EACH OCCURRENCE
$ 1 000000
PREMISES (Ea occurrence)
$ 1, 000, 000
MED EXP (Any one person)
6 10, 000
X
PERSONAL B ADV INJURY
$ 1, 000, 000
GENERAL AGGREGATE
$ 2, 000, 000
N'L
AGGRE
POLICY
e
X
LIMIT APPLIES PER:
PRO- O LOC
PRODUCTS - COMP/OP ASS
$2, 000, 000
$
A
AUTOMOBILE
LABILITY
ANYAUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON -OWNED AUTOS
65 UEC NG0378
10/04/2011
10/04/2012
COMBINED SINGLE LIMIT
IEa acc(dend
$ 1, 000, 000
BODILY INJURY (Per person)
$
BODILY INJURY (Per eccidenO
$
X
PROPERTY DAMAGE
IPm eccideru)
$
$
$
A
X
WBRELLA LIAR
EXCESS LMB
X
OCCUR
CLAIMS -MADE
65 SBM TB8424
10/04/2011
10/04/2012
EACH OCCURRENCE
$ 1, 000, 000
AGGREGATE
$ 1, 000, 000
DEDUCTIBLE
RETENTION $ 10 000
$
X
$
WO RS COMPENSATION
L
ANOEMPLOYERS'LfTY YIN
ANY PROPRIETORMARTNERAiXECUTIVEE
OFFICERIMEMBER EXCLUDED)
(M O.rr it NH)
If yes, describe under
DESCRIPTION OF OPERATIONS W.l
NIA
WC STATU- OTM-
TORY UNITS ER
E.L. EACH ACCIDENT
6
E.L. DISEASE - EA EMPLOYE
$
E.L DISEASE - POUCY UNIT
$
Single Owner LLC - no employee.
DESCRPTION OF OPERA "OW /LOCATIONS/VEIBCL ES (Affx ACORO 101, AddRbnN .Sa•Mdub. B,m,a ayxaunpuiadl
Those usual to the Insured's Operations.
CERTIFICATE HOLDER CANCELLATION
City
of Fort Collins
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED
Attn
: Monty Wagner
BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE
300
LaPorte Ave
DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS.
AUFNORII£O REPRESEN ATR/E
PO BOX 580
FORT
COLLINS, CO 80522
�iL� IeLf r�
0 1988-2009 ACORD CORPORATION. All rights reserved.
ACORD 25 (2009/091 The ACORD name and logo are registered marks of ACORD