HomeMy WebLinkAboutCOLORADO SASH & DOOR INC - INSURANCE CERTIFICATE (3)CERTIFICATE OF LIABILITY INSURANCE OF ID DA
DATEIMMIDDII'YYY)
06 11 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 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
UUN IA
NAME:
AIC, No, Ext : ("VC, No):
Brown & Brown Inc
ADDRESS:
4532 Boardwalk Dr, Suite 200
FOIL Collins CO $0525
CUSTOMER ID P: COSAS-1
Phone:970-482-7747 Fax:970-484-4165
INSURERS) AFFORDING COVERAGE
NAICN
INSURED
INSURER A: AMCO Insurance Company
19100
Colorado Sash & Door, Inc
P. O. Box 270682
INSURER : Depositor. xssarasce Company
425$7
INSURER C: Pinnacol Assurance Company
41190
Fort Collins CO 80527
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 CONTRACTOR 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.
LTR
TYPE OF INSURANCE
INSRI
WVD
POLICY NUMBER
(MMIODIYYYY)
(MMIDD/VYYY)
LIMITS
A
GENERAL LIABILITY
X COMMERCIAL GENERAL LIABILITY
X CLAIMS -MADE OCCUR
'
X
ACP7514152079
12/08/11
12/08/12
EACH OCCURRENCE
$ 1,000,00
PREMISATES�eoc�r0ence
$300,000
MED EXP(Any one person)
$5,000
PERSONAL B ADV INJURY
$1,000,000
'- -
GENERAL AGGREGATE
$ 2,000,000
GENT AGGREGATE LIMIT APPLIES PER:
POLICY n JECOT n LOC
PRODUCTS - COMP/OP AGG
$2,000,000
$
B
AUTOMOBILE
LIABILITY
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIREDAUTOS
NON -OWNED AUTOS
ACP7514152079
-
12/08/11
12/08/12
COMBINED SINGLE LIMIT
(Ea accident)
$11000,000
X
BODILY INJURY (Per person)
S
BODILY INJURY (Per accident)
$
PROPERTY DAMAGE
(Per accident)
$
$
S
A
IX
UMBRELLA LIAR X
EXCESS LIAR I
I
OCCUR
I CLAIMS -MADE
ACP7514152079
12/08/11
12/08/12
1
EACH OCCURRENCE
S 1,000,000
AGGREGATE
$ 1,000,000
X I
DEDUCTIBLE
RETENTION $ D
s
$
C
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY YIN
ANY PROPRIETORIPARTNER/EXECUTIVEL]
OFFICEIRMEMBE
(Mandatory in NH)
8 yes, describe under
DESCRIPTION OF OPERATIONS sets.
MIA
4024240
06/01/12
06/01/13
X -
TORY LIMITS ER
E.L. EACH ACCIDENT
$500,000
E.L. DISEASE - EA EMPLOYEE
$ 5 0 0 , 0 0 0
E.L. DISEASE -POLICY LIMIT 1
$500,000
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, H more space is pi
CERTIFICATE HOLDER CANCELLATION
City of Fort Collins
Utility Department
700 Wood St.
Fort Collins CO 8052
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
UTILFTC I THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
ACORD 25 (ZU09109)
ACORD
The ACORD name and logo are registered marks of ACORD
reserved.