HomeMy WebLinkAbout414759 SWINGLE INC - INSURANCE CERTIFICATESWING-2 OP ID: LIZ
'4`� �' CERTIFICATE OF LIABILITY INSURANCE
DAT01/20O/YVYV)
ov2o/12
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(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 303-799-0110
NAMEACT Gail Clark
Cherry Creek Ins. Agency, Inc.
Suite 500 303-799-0156
5660 Greenwood Plaza Blvd.
PHONE FAX
laEll,c No 720-212-2056 A/C, Nol: 303-799-0156
EMAIL
ADDRESS: GailC@thinkccig.com
Greenwood Village, CO 80111
Steven L. Doss
INSURER(S) AFFORDING COVERAGE
NAIC N
INSURERA:Old Republic Ins. Company
INSURED Swingle, Inc
INSURER B: Firemans Fund Ins Co
8585 E Warren Ave
Denver, CO 80231
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 ADDL SUBAPOLICY EFF POLICY EXP
LTR TYPE OF INSURANCE INSR MO POLICY NUMBER MM/DDIYYYV MMIDDIYYYV LIMITS
GENERAL LIABILITY
EACH OCCURRENCE
$ 1,000,00
A
X COMMERCIAL GENERALLIABILI Y
X
MWZY59554
02101/12
02/01/13
PREMISES Ea occurrence_
$ 300,00
CLAIMS -MADE I —XI OCCUR
MED EXP (Any one person)
$ 10,00
PERSONAL B ADV INJURY
$ 1,000,00
GENERAL AGGREGATE
$ 2,000,00
GEN L AGGREGATE LIMIT APPLIES PER:
PRODUCTS - COMPIOP AGG
$ 2,000,00
$
POLICY X PROIECT LOC
AUTOMOBILE LIABILITY
COMBINED SINGLE LIMIT
Ea accident
8 1,000,00
BODILY INJURY (Per person)
$
A
X ANY AUTO
MWTB21506
02/01112
02101/13
ALL OWNED SCHEDULED
AUTOS AUTOS
BODILY INJURY (Per accident)
$
PROPERTY DAMAGE
Peraccidenl)
$
NON -OWNED
HIRED AUTOS AUTOS
X
UMBRELLA LIAR
X
OCCUR
EACH OCCURRENCE
$ 2,000,00
AGGREGATE
$ 2,000,00
B
EXCESS LIAR
CLAIMS -MADE
SSE48563514
02/01112
02/01113
DED I I RETENTION $
$
A
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY
ANY PROPRIETORIPARTNER/EXECUTIVE YIN
OFFICERIMEMBER EXCLUDED? F
IMandamry in NH)
NIA
MWC11735500
02/01/12
l02/01/13
X NG STATUS OTH-
TORY LIMITER
EL. EACH ACCIDENT
$ 1,000,00
EL.DISEASE -EA EMPLOYEE
$ 1,000,00
If yes describe under
DESCRIPTION OF OPERATIONS below
E. L. DISEASE -POLICY LIMIT
$ 1,000,00
DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, it more space is required)
As required by written contract or written agreement, the Certificate Holder
is included as Additional Insured under General Liability.
City of Fort Collins
Attn: Purchasing Division
PO 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
@ 1988-2010 ACORD CORPORATION. All rights reserved.
ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD