Loading...
HomeMy WebLinkAbout458840 C & S SPECIALTY SYSTEMS INC - INSURANCE CERTIFICATE (5)ac=ofCERTIFICATE OF LIABILITY INSURANCE �/ - D/DD"YYY' 2/8/28/2012 THIS CERTIFICATEAS 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 CONTACT Johna Moors _ - NAME: PHONE (303) 674-5501 pIC No .(303)674-3571FAX - '- Colorado "BW Insurance Agency, Inc. E-MAILS,,johna.moors@bankofthewest.com A R .johns. moors@bankofthewest.com Box'3849 _ - - INSURERS AFFORDING COVERAGE NAIC 4 INSURER A:Scot tsdal a Ins Co Evergreen CO 80437 INSURED INSURERB:State Auto Insurance Companies INSURER C:Pinnacol Assurance 41190 C & S Specialty Systems Inc. INSURER D: 5609 W 6th Ave., Unit B INSURER E INSURER F: Lakewood CO 80214 COVERAGES CERTIFICATE NUMBER:2012-2013 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 LTR I TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF MMIDD/YYYV POLICY EXP MMoDIYYYY LIMITS GE N ERALUABILITY EACH OCCURRENCE $ 1, 000, 000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED PREMISES Ea occurrence $ 100, 000 A CLAIMS-MADEOCCUR 7PS1546090 /8/2012 2/8/2013 MED EXP(Any one person) $ 5,000 PERSONAL B ADV INJURY $ 1, 000, 000 GENERAL AGGREGATE $. -2, 000, 000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMPIOP AGO $ - "included X POLICY PRO- LOC " ---$- - AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT C. accident 1 000 000 BODILY INJURY (Per person) _ $ _ .. -.. B ANY AUTO - - BODILY INJURY $ ALL OWNED SCHEDULED AP222069303 /1/2011 /1/2012 J _ AUTOS - AUTOS (Per accident) " PROPERTY DAMAGE $ NON -OWNED HIRED AUTOS AUTOS Per accident Uninsured motorist Blsplit limit $ 1 000 000 00 X UMBRELLA LAB X OCCUR EACH OCCURRENCE $ 4, 000, 000 AGGREGATE $ 4, 000, 000 A E%CESS LIAB CLAIMS -MADE DED X I RETENTION$ 10,000 $ FKBS0020409 2/8/2012 /8/2013 C WORKERS COMPENSATION WC STATU- OTH- ANDEMPLOYERS' LIABILITY YIN -ER E.L. EACH ACCIDENT $ 1, 000, 000 ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) NIA g143782 2/1/2012 2/1/2013 E.L. DISEASE -EA EMPLOYE $ 1, 000, 000 If yes, describe under E. L. DISEASE -POLICY LIMIT $ 1 000,000 DESCRIPTION OF OPERATIONS below A Professional Liability PS1546090 2/8/2012 /8/2013 - - 1M per occur 2M aggregate DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schad ule, if more space is required) City of Fort Collins P.O. Box 580 Fort Collins, CO 80522 ILL�L`I 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 AUUHU 25 (ZU1U/Ub) INS025 (201005).01 Carol Reinoehl/EVECR 22--u---z-f^-� © 1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD