HomeMy WebLinkAboutPRIMAL ECHO LLC - INSURANCE CERTIFICATE (3)Client#: 51254
PRIEC
ACORD CERTIFICATE OF LIABILITY INSURANCE
DATE"""DD"`YY)
,0/21/2011
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 AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURERS), 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 endorsement(s).
PRODUCER
Flood & Peterson Ins., Inc.
1
P. O. Box 578
Greeley, CO 80632
970 356-0123
CONTACT
NAME:
_
PHONE 970 356-0123 9703301867
NC No Ell; A/C, No
-
ADDRESS:
CUSTOMER IOC
INSURER(S) AFFORDING COVERAGE
HAD
INSURED Primal Echo, LLC
305 W. Magnolia, #285
Fort Collins, CO 80521
'
INSURER A: Auto -Owners Insurance Group
INSURER a:
INSURER C:
INSURER 0:
INSURER E :
1
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.
LTIL
TYPE OF INSURANCE
POLICY NUMBER
EFF
MM�DDfYYY
MINDD/YYYV
LIMBS
A
GENERAL LIABILITY
X COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE � OCCUR
1023327463697411
i
I
11/19/2011
11/19/201
EACH OCCURRENCE
$1 000 000
DAMAGE
PREMISES Ea occurrence
3300000
MED EXP (Any one person)
$10,000
PERSONAL BADVINJURY
$1,000,000
GENERAL AGGREGATE
$2,000,000
GENL AGGREGATE LIMIT APPLIES PER
POLICY PRO- LOC
PRODUCE-COMP/OP AGO
s2000,000
$
AUTOMOBILE
LIABILITY
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON -OWNED AUTOS
COMBINED SINGLE LIMIT
(Ea accident
$
BODILY INJURY (Per person)
$
BODILY INJURY (Per accident)
$
PROPERTY DAMAGE
(Peraccident)
$
$
RELLA LIAB
ESS LIAB
OCCUR
CIAIMS-MADE
EACH OCCURRENCE
$
AGGREGATE
$
UCTIBLE
RETENTION
FANDEMPLOYERS'
S
$
S COMPENSATION
LOYERS' LIABILITY YINMIT,
PRIETOFVPARTNERIEXECUTIVE❑
IMEMBER EXCLUDED?NIAry in NH)
criTION OF OPERATIONS below
wC STATU} OTH-
E.L. EACH ACCIDENT
$
E.L. DISEASE - EA EMPLOYEE
$
E.L. DISEASE - POLICY LIMIT i
$
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space 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 0 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
ACORD 25 (2009109) 1 Of 1
#S653664/M653663
01988-2009 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD
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