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HomeMy WebLinkAbout148485 RANDEL S COOPER DBA ACCU CLEAN SERVICES - INSURANCE CERTIFICATEA COR "' CERTIFICATE OF LIABILITY INSURANCE DATE(MIAID) 06/05/2012 012 PRODUCER Pinnacol Assurance - THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY 7501 E Lowry Blvd AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS Denver, CO 80230-7006 CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE NAIC# - INSURED Randel S Cooper dba Accu Clean Services INSURER A: Pinnacol Assurance 41190 INSURERB. 736 Gallup Road Fort Collins, CO 80521 INSURER C'. INSURER 0: INSURERE' COVERAGES 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 DOCUMMENT 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 ADD POLICY EFFECTIVE POLICY EXPI RATION LTR INSRD TYPE OF INSURANCE POLICY NUMBER OATE(MMJDDIYYVY) DATE(MMIDDNYYY) LIMITS GENERAL LIABILITY EACH OCCURRENCE DAMAGE TO RENTED PREMISES COMMERCIAL GENERAL LIABILITY CLAIMSMADE OCCUR MEDEXPAn anaperson) PERSONAL 6 ADV INJURY GENL AGGREGATE LIMIT APPLIERS PER: GENERAL AGGREGATE PRODUCTS-COMPIOPAGG POLICY 11 PROJECT TOO AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT, ANY AUTO (Ee A¢beN) BODILY INJURY ALL OWNED AUTOS SCHEDULEDAUTOS (Perperiand ROPILY INJURY HIRED AUTOS NON OWNED AUTOS (PerattNenl) PROPERTY DAMAGE (Per eccdenl) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT OTHERTHAN EA ACC ANY AUTO AUTO ONLY: AG EXCESSNMBRELLA LIABILITY EACH OCCURRENCE AGGREGATE OCCUR CLAIMS MADE DEDUCTIBLE RETENTION $ WORKERS COMPENSATION AND X WC STATU- OTHER A EMPLOYERT LIABILITY ANY PROPRIETOR)PARTNERIENECUTIVE OFFICERIMEMBER EXCLUDED' 4001894 06/01/2012 06/01/2013 ORV LIMITS E.L EACH ACCIDENT $100.000 E.L DISEASE - EA EMPLOYEE $100.000 11 yes, please describe under SPECIAL PROVISIONS below E.LDISEASE-POLICYLIMIT $00000 OTHER DESCRIPTION OF OPERATIONSILOCATIONSIVEHICLESIEXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS Reference: Accu-Clean CERTIFICATE HOLDER CANCELLATION 1387784 SHOULD ANV OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Fort Collins THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO John Stephen MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE PO Box 580 LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR Fort Collins, CO 80522 LIABILITY OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE Timothy Hurd ACORD 25(2001I08) Underwriter ACORD CORPORATION 1988