HomeMy WebLinkAboutREEVES SPECIALTY SERVICES INC - INSURANCE CERTIFICATE1.. R CERTIFICATE OF LIABILITY INSURANCE
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DATE (MM/)
3/16/2012012
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
Keller -Lowry Insurance Inc
S Harrison St #700
Denver CO 80210
CONTACT Teresa Hell el
NAME: P
PHONE . (303) 756-9909 P / No: (303)756-8818
Pan1777
ADDRESS ,icanhelp@kellerlowry.com
INSURERS AFFORDING COVERAGE
NAIC #
INSURER A:Peerless IndeannitV
18333
INSURED
Reeves Specialty Services, Inc.
PO Box 472585
Aurora CO 80017
INSURERB:Plnnacol Assurance
41190
INSURER C:
INSURER D:
INSURER E
INSURER F:
r nVFRAI CERTIFICATE NUMBER:12-13GL,AU,WC,UM,EQ 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.
ILTR
ADDL
SUBR
POLICY EFF
POLICY EXP
TYPE OF INSURANCE
POLICY NUMBER
MM/DDnY1'YY)
fMIMUDDIYYYY1
LIMITS
GENERAL LIABILITY
EACH OCCURRENCE
$ 1,000,000
X COMMERCIAL GENERAL LIABILITY
PREMISES La occurrenceoccurrencel
S 100,000
A
CLAIMS -MADE OOCCUR
CBP8834194
/1/2012
/1/2013
MED EXP(Any one person)
S 15,000
PERSONAL &ADV INJURY
S 1,000,000
X BLKT ADDITIONAL INSURED
PER 22-127 0106/22-132
X
BLKT WAIVER OF SURBO
GENERAL AGGREGATE
$ 2,000,000
X
X
PER 22-126 0108/22-133
GENT AGGREGATE
LIMIT APPLIES PER:
PRODUCTS - COMP/OP AGG
$ 2,000,000
$
17 POLICY
RO LOC
X PIFCIT
AUTOMOBILE
LIABILITY
(Ea BI EDtSINGLE LIMIT
$ 11000,000
BODILY INJURY (Per person)
$
ANY AUTO
A
BODILY INJURY (Per ascidem)
S
ALL OWNED SCHEDULED
8834494
/1/2012
/1/2013
I
AUTOS AUTOS
PROPERTY DAMAGE
Per accident
S
NON -OWNED
HIRED AUTOS AUTOS
Endorsements
S
X
UMBRELLA LIAB
X
OCCUR
EACH OCCURRENCE
$ 4,000,000
AGGREGATE
$ 4,000,000
A
EXCESS LIAB
CLAIMS -MADE
DED I X I RETENTIONS 10,OOC
$
CU6834994
/1/2012
/1/2013
B
WORKERS COMPENSATION
XI WC STATU- I OTH-
I To Y LIMITS ER
AND EMPLOYERS' LIABILITY YIN
ANFICER/MEIMBOEREXCLUDEDXECUTIVE
EL. EACH ACCIDENT
$ 1,000,000
y
N/A
079921
/1 /2012
/1 /2013
(Mandatory In NH)
E.L. DISEASE - EA EMPLOYEd
S 1,000,000
It yes, describe under
DESCRIPTION OF OPERATIONS below
E.L. DISEASE-PDLICYLIMIT
S 1,000,000
A
LEASED & RENTED EQUIPMENT
BP8834194
/1/2012
/1/2013
MAX LIMIT - $25,000
DED $1, 000
DESCRIPTION OF OP ATIONSI LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required)
Certifica Holder�is Additional Insured, with Waiver of Subrogation, for General Liability as required
by writt contract ith Insured subject to the terms and conditions of the policy contract.Additional
Insured,' Waiver o Subrogation and Primary Non -Contributory coverage per policy forms attached.
r
City of Fort Collins
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
01051
T Sibelius CIC CRN/TM
INS025 (201005).01 The ACORD name and logo are registered marks of ACORD