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Home My WebLink About103009 PORTER INDUSTRIES INC - INSURANCE CERTIFICATE (23)NCCLE Client#: 14405 ACORD. CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DDNYYY) 02/07/2012 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 Flood & Peterson ins., Inc. P. O. Box 578 Greeley, CO 80632 970 356-0123 CONTACT NAME: Kelly Beauvais PAONE Ert 970 266-7121 AY, No970 506-6846 E-MAIL KeIIy.Beauvais@floodandpeterson.com CUSTOMERID#: INSURER(S) AFFORDING COVERAGE NAIC # INSURED INSURER A: Travelers Insurance Company Northern Colorado Cleaning, LLC dba Porter Industries, Inc. 5202 Granite Street INSURER BPinnacol Assurance INSURER C Loveland, CO 80538 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 LTR TYPE OF INSURANCE DDL NSR UBR NVD POLICY NUMBER POLICY EFF MM/DD/VYVY POLICY EXP MWDD/YYYY LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE 17viOCCUR 6302BS55731 2/05/2012 02/05/2012 EACH OCCURRENCE $1 000 000 PREMISES Ead. eMA08 TO nce s3000OO MED EXP (Any one person) $10,000 PERSONAL & ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: JECT X POLICY X PRO LOC PRODUCTS - COMP/OP AGG s2,000,000 $ A AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON-OWNEDAUTOS 8102B955731 2/05/2012 02/05/2012 )SINGLE LIMIT (Ea accident) $1,000,000 X BODILY INJURY (Per person) $ BODILY INJURY (Per eccidenl) $ PROPERTY DAMAGE (Per acoieenl) $ X X S $ A X UMBRELLA LIAR EXCESS LIAB X OCCUR DLAIMS-MADE - CUP261955731 - -' 2/05/2012 02tO5/2013 EACH OCCURRENCE $1 000000 AGGREGATE S1,000,000 DEDUCTIBLE RETENTION 10000 $ X $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITYEB ANY PROPRIETORIPARTNEWEXECUTIVEY/N OFFICEWMEMBER EXCLUDED? (Mandatory In NH) It yyes,Uescribe under DE SGRIPTION OF OPERATIONS below N/A 4153522 2/05/2072 07/01/207 X WC STATU- OTH- E.L. EACH ACCIDENT $1,000,000 E.L. DISEASE - EA EMPLOYEE $1,000,000 E.L. DISEASE -POLICY LIMIT $1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 1 D1, Additional Remarks Schedule, H more space Is required) City of Fort Collins Building & Permit Dept. Fossil Ridge Maintenance 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. ACORD 25 (2009/09) 1 of 1 #S675087/M675056 01988-2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD KLB Client#: 14405 IIRITAMIA ACORD. CERTIFICATE OF LIABILITY INSURANCE DATE(MM02/07/2012YY) 012 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 Flood &Peterson ins., Inc. P. O. Box 578 Greeley, CO 80632 970356-0123 CONTACT NAME: Kelly Beauvais PHONE g70 266-7121 970 506-6846 A/C No EIJ: A/Q No E-MAIL ADDRESS: Kelly.Beauvais@floodandpeterson.com Beauvais@floodand eterson.com CUSTOMER ID N: INSURER(S) AFFORDING COVERAGE NAICIF INSURED INSURER A: Travelers Insurance Company Northern Colorado Cleaning, LLC Gibe Porter Industries, Inc. 5202 Granite Street INSURER BPinnacol Assurance INSURER C: Loveland, CO $0538 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 LTR OF INSURANCE NOOTYPE ML D POLICY NUMBER MMIDDNYYY MWDDNYYV LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS MADE a OCCUR 6302B955731 2/05/2012 02105/2013 EACH OCCURRENCE $1 000 000 DAMAGE TO RENTED PREMISES (Ea occurrence) s300 OOO NED EXP(Any one person) $10,000 PERSONAL &ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMITAPPLIES PER: JECT X POLICY X PRO LOC PRODUCTS - COMPIOP AGG s2,000,000 $ A AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS 8102B955731 2/05/2012 02/05/2013 COMBINED SINGLE LIMIT (Ed accident) $1000000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ 1XX PROPERTY DAMAGE (PeraccidenI)NON-OWNEDAUTOS $ A X UMBRELLA LIAR EXCESS LIAR OCCUR CLAIM$ MADE CUP2B955731 2105/201202/05/201 EACH OCCURRENCE $1OD000O N AGGREGATE $1 oOO OOO DEDUCTIBLE RETENTION 10000 $ X $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETORIPARTNEIVEXECUTIVE —1 OFFICENMEMBER EXCLUDED' (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N/A 4153522 2/O5/2012 07/01/201 X WG STATU- DTH- E.L. EACH ACCIDENT $1,000 000 E.L. DISEASE -EAEMPLOYEE $1,000,000 EL.DISEASE-POLICY LIMIT $1,DDD,DDO DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (AfMch ACORD 101, Additional Remarks Schedule, K more space is required) RE: Carpet Maintenance 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 Attn: James B O'Neill 215 North Mason Street Second Floor 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 dye +n//sL.:._ ACORD 25 (2009/09) 1 of 1 #S675086/M675056 @ 1988.2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD KLB