Loading...
HomeMy WebLinkAboutPEAK ELEVATOR PERFORMANCE GROUP - INSURANCE CERTIFICATE (4)PEAKELE-01 SKOSTER ,4�� CERTIFICATE OF LIABILITY INSURANCE °AT5/3/2o sw' 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- - --- - - CoBiz Insurance, Inc. -CO I 821 17th St. Denver, CO 80202 CONTACT NAME: PHONEo Nc NEX1 (303) 988-0446 Fa"c No :,(303) 988-0804 . n0 RIESS: INSURER(S) AFFORDING COVERAGE NAICM INSURER A: Scottsdale Indemnity Company 15580 INSURED INSURERS: Cincinnati Casualty Company 28665 Peak Elevator Performance Group Inc. INSURERC: Pinnacol Assurance Company 41190 5156 W 58th Ave Suite B INSURER D: INSURER E: Arvada, CO 80002 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 POLICY NUMBER MM/DDYIYYYY MM/DDIYYYY LIMITS A ' GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE [A] OCCUR - BCS0027729 - - 5/3/2012 5/3/2013 - EACH OCCURRENCE $ 2,000,000 PREMISES Eaaccurrence S 100,000 MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY 3 '$ - - 2,000,000 --- GENERAL AGGREGATE . $ 4,000,000 GEN'LAGGREGATELIMIT APPLIES PER : - POLICY X PRO- LOC JECTAUTOMOBILE PRODUCTS - COMP/OP AGO $ '4,000,000 $ B LUIBNTY X ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS HIRED AUTOS NON -OWNED AUTOS _ ENP61139291 -. 6/3/2012 5/3/2013 Ee adeDISINGLE LIMIT- $ 1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Par accitlenQ $ PROPERTY DAMAGE Per accident $ $ A UMBRELLA DAB EXCESS LIAB X OCCUR CLAIMS -MADE XLS0081844 5/3/2012 5/3/2013 EACH OCCURRENCE $ 2,000,000 X AGGREGATE $ 2,000,000 DEO RETENTION $ $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNERIEXECUTIVE Y/N OFFICER/MEMBER EXCLUDED? (MandalorylnNH) If yes, desmbe untler OE as.OF OPERATIONS below NIA 4147864 _ 5/1/2012 5/1/2013 - X WC STATU- OTH- RY I E 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 I LOCATIONS I VEHICLES (Adach ACORD 101, Addidonal Remarks Schedule, B mom space Is nqumd) k cm I Iri iA I m m VLUCR City's Director of Purchase & Risk Management 215 N Mason 2nd Floor 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