HomeMy WebLinkAbout265716 WINDOW KING - INSURANCE CERTIFICATE (6)/ 1 ®
,4coRo CERTIFICATE OF LIABILITY INSURANCE
DATE(MWDD
11/11/2011
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 INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(les) 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
WEEDIN AGENCY INC
PO Box 55
Loveland, CO 80539
CONTACT
NAME'
a°No (970)667-2145 A/C140070)669-9295
ADD RIEss annette@weedinagency.com
INSURER(S) AFFORDING COVERAGE
NAIC/
INSURER A: OWNERS INSURANCE CO
INSURED WINDOW KING #111, INC
JAMES GOEBEL
1383 WARBLER ST
LOVELAND, CO 80537
970-391-2223
INSURER B:
INSURER C:
INSURER D:
INSURER E:
1 INSURER F
COVFRAGFS CERTIFICATE NUMBER' REVISION NUMBER:
THIS 15 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.
I�TR
TYPE OF INSURANCE
ADDL
INSR
SUER
SUB
POLICY NUMBER
POLICY
MMILICY E Y
POLICY EXP
M OLICY EXP
LIMITS
GENERAL LIABILITY
EACH OCCURRENCE
$ 1,000,000
PREMISES Ea occurrence
$ 200 5 0
X COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE EI OCCUR
MED EXP(Any one person)
$ 5 000
A
Y
74932794
8/27/118/27/12
PERSONAL BADVINJURY
$ 1,000,000
GENERAL AGGREGATE.
$ 3,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
PRODUCTS - COMP/OP AGG
$ 3,000,000
X POLICY PRO- LOC
�$
AUTOMOBILE LIABILITY
COMBINED SINGLE LIMIT
Ea accidnte
$ 1,000,000
BODILY INJURY (Per person)
BODILY INJURY (Per accident)
$
$
A
X ANVAUTO
ALL OWNED SCHEDULED
AUTOS AUTOS
Y
4848313900
8/27/118/27/12
NON -OWNED
HIRED AUTOS HAUTOS
PROPERTY I1AMh!GE
Per accident
$
A
x
UMBRELLA LIAB
E%CESSLIAB
OCCUR
CLAIMS -MADE
Y
48483139
9/29/110e/27/12
FACM OCCURRENCE
s 2,000,000
6
AGGREGATE
$ 2,000,000
DED RETENTION$
$
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY YIN
ANY PROPRIETORIPARTNERIEXECUTIVE ❑
OFFICERIMEMBER EXCLUDED?
NIA
WC STATU- OTH-
V IMIT ER
E.L. EACH ACCIDENT
$
E.L. DISEASE - EA EMPLOYE
$
Mandatory In NH)
If yes, describe under
DESCRIPTION OF OPERATIONS below
E.L. DISEASE -POLICY LIMIT
$
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required)
CITY OF FORT COLLINS PURCHASING DIVISION IS LISTED AS ADDITIONAL 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
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