HomeMy WebLinkAboutPRIMAL ECHO LLC - INSURANCE CERTIFICATE (2)Client#: 51254
PRIEC
ACORD CERTIFICATE OF LIABILITY INSURANCE
DATE(MM/DWYYYY)
F
10/21/2011
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 AN.END, 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 Ileu of such endorsement(s).
PRODUCER
ONTACT
NAME:
Flood & Peterson Ins., Inc.
PHONE 970 356-0123 9703301667
A/C No Ell: A/C, No
P. O. Box 578
Greeley, CO 80632
ADDRESS:
970356-0123
CUSTOMER ID s:
INSURERS) AFFORDING COVERAGE
NAICI
INSURED
INSURER A: Auto -Owners Insurance Group
Primal Echo, LLC
305 W. Magnolia, #285
INSURER B
Fort Collins, CO 80521
INSURER C:
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
TYPE OF INSURANCE
4DDL
SUB
POLICY NUMBER
POLICY
MWDDFF
/Y
WDD/VYP
LIMITS
A
GENERAL LIABILITY
1023327463697411
11/19/2011
11/1912012
EACH OCCURRENCE
$1 000 000
X COMMERCIAL GENERAL LIABWN
CLAIMS -MADE FXIOCCUR
PREMISES Ea occurrence
s3000OO
MED EXP (Any we person)
$10,000
PERSONAL& ADV INJURY
$1,000,000
GENERAL AGGREGATE
$2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
PRODUCTS - COMP/OP AGG
$2,000000
PRO- LOC
POLICY 71
1
1
$
AUTOMOBILE
LIABILITY
COMBINED SINGLE UMIT
(Ea amiden q
$
ANY AUTO
BODILY INJURY (Per perscn)
$
ALL OWNED AUTOS
BODILY INJURY (Per accident)
$
SCHEDULED AUTOS
HIREDAUTOS
PROPERTY DAMAGE
(Per accident)
$
$
NON -OWNED AUTOS
$
UMBRELLA LIAR
OCCUR
EACH OCCURRENCE
$
AGGREGATE
$
E%CESS LIAB
CLAIMS -MADE
DEDUCTIBLE
$
S
RETENTION
WORKERS COMPENSATION
WCS I I OTH-
AND EMPLOYERS' LIABILITY Y/N
ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICER/MEMBER EXCLUDED?
N/A
E.L EACH ACCIDENT
S
E.L. DISEASE- EA EMPLOYEE
S
(Mandatory In NH)
If yes, descnW under
DESCRIPTION OF OPERATIONS below
E.L. DISEASE- POLICY OMIT
$
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional RemaM Schedule, it more apace is required)
Certificate holder is included as Additional Insured as required by written contract with respects to
liability arising out of work performed by the named insured.
City of Fort Collins, Purchasing
Division
P O Box 580
Fort 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 REPRESENTATIVE
e6ea occ2 0 egA4:�
U1988-2009 ACORD CORPORATION. All rights reserved.
ACORD 25 (2009/09) 1 Of 1
#S653664/M653663
The ACORD name and logo are registered marks of ACORD
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