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HomeMy WebLinkAbout277398 CHOICE TOWING LLC - INSURANCE CERTIFICATE (2),a`oRo CERTIFICATE OF LIABILITY INSURANCE DATE (mrr 03/12/12 2/12 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 CERTICATE 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 endorsements . PRODUCER Zurich, Account Service Center 7045 College Blvd. CONTACT Zurich N.A.-Account Service Center NAME: AC PHONE EXr : 877-225-5276 FAX ac No): 888-734-6776 Overland Park, KS 66211 888-734-6776 Ph: 877-225-5276 Opt. 1 E-MAIL s: semice.center@zurichna.com INSURERS AFFORDING COVERAGE NAIC # INSURED 0143467-00 CHOICE TOWING, LLC. �,�1 �S 0 INSURER A: Universal Underwriters Insurance Company 41181 INSURER B: Universal Underwriters of Texas Ins. Co. 40843 1605 E. LINCOLN INSURER C: FORT COLLINS, CO 80524 INSURER D: INSURER E: 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 DD'L 3UBF POLICY NUMBER POLICY EFF MM/DO POLICY EXP MM/DD/V LIMITS A GENERAL LIABILITY El ❑ EACH OCCURENCE s300,000 DAMAGE RENTED $ ® COMMERICAL GENERAL LIABILITY ❑❑ CLAIMS MADE ® OCCUR PREMISESS Ea occurrence) ( ❑ 314055 03/16/12 03/16/13 MED EXP (Any one person) $ — ❑ PERSONAL S ADV INJURY — GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER. PRODUCTS - COMP/OP AGO $ ❑ POLICY ❑ PROJECT ❑ LOC A AUTOMOBILE LIABILITY ❑ ❑ COMBINED SINGLE LIMIT Accident) $ 300,000 ❑ ANY AUTO (Ea BODILY INJURY (Per person) $ ❑ALL OWNED AUTOS BODILY INJURY (Per accident) $ ® SCHEDULED AUTOS 314055 03/16/12 03/16/13 PROPERTY DAMAGE Per accident $ ® HIRED AUTOS $ ® NON -OWNED AUTOS A ® UMBRELLA LIAB ® OCCUR ❑ ❑ EACH OCCURRENCE s 2,000,000 AGGREGATE $ ❑ EXCESS LIAB ❑ CLAIMS -MADE 314055 03/16/12 03/16/13 ❑DEDUCTIBLE PRODUCTS - COMP/OPAGG $6,000,000 ® RETENTION $_0 $ WORKERS COMPENSATION AND ❑ WC STATU- ❑ OTH- EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNEILEXECUTIVE Y/N TORY LIMITS ER E, L. EACH ACCIDENT $ OFFlCEWNEMBERExCUlDED4 ❑ N/A❑ E.L. DISEASE -EA EMPLOYEE $ MI In NH) If yes, describe under E.L. DISEASE - POLICY LIMIT DESCRIPTION OF OPERATIONS below A GARAGE LIABILITY ❑ ❑ 314055 03/16/12 03/16/13 OTHER THAN AUTO ONLY $'300000 EACH OCC: A Includes On -Hook Coverage ❑ ❑ 314055 03/16/12 03/16/13 $450,000 Limit Customer Auto -Direct Primary DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) Reason for Certificate: General Liability. 30 day notice of cancellation applies, except for cancellation due to non-payment of premium. See Additional Remarks Schedule Attached CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE CITY OF THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN FT. COLLINS ACCORDANCE WITH THE POLICY PROVISIONS. PURCHASING DIVISION 215 NORTH MASON STREET, 2ND FLOOR AUTHORIZED REPRESENTATIVE FORT COLLINS, CT 80522 ©1988-2010 ACORD CORPORATION, All rights reserved ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD IMPORTANT If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). 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). DISCLAIMER The Certificate of Insurance on the reverse side of this form does not constitute a contract between the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon. 9)1988-2010 ACORD CORPORATION, All rights reserved ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: 014346700 LOC #: ADDITIONAL REMARKS SCHEDULE Page_3_of-3— AGENCY NAMEDINSURED Zurich, Account Service Center CHOICE TOWING, LLC. 1605 E. LINCOLN FORT COLLINS, CO 80524 POLICY NUMBER 314055 CARRIER NAIC CODE Universal Underwriters Insurance Company 41181 __„-- ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: Certificate Of Liability Insurance Products - Completed Operations Aggregate of $900,000 applies to the Garage Liability. Includes On -Hook Coverage. Certificate Holder is named as an Additional Insured. ACORD 101 (2008/01) © 2008 ACORD CORPORATION, All rights reserved. The ACORD name and logo are registered marks of ACORD