Loading...
HomeMy WebLinkAbout168310 SCHRADER OIL - INSURANCE CERTIFICATESCHRA-1 OP ID: GRTI CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY) 03/27/12 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 terns 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 endorseme s . ER L�egoac�y Insurance Network 719S93S814 1827 Briargate Blvd 719-388-2075 Colorado Springs, CO 80920 Tim Gries Na#EACT : Tim Gries PHONE .719S93S814 FAX No : 719-388-2075 E-MAIL ADDRESS: tim gries@yahoo.com #INSURER O A: UniteINSURED Schrader Oil 320 N College INSURER B: PInn INSURER C: 7MA Ft Collins, CO 80524 INSURER D: INSURER E : INSURER , __......_...IAIUIV NUMr31:R: 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 NSR TYPE OF INSURANCE POLICiYNUMBER 06LICYEFF POLICYEXP LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CWMS-MADE OCCUR 5068708038 06/30/12 06130/13 EACH OCCURRENCE $ 1,000,00 dO PREMISES eoccunDence $ 100,00 MED EXP(Any one person) $ 6,00 PERSONAL B ADV INJURY $ 1,000,00 GENERAL AGGREGATE s 2,000,00 GENL AGGREGATE LIMIT APPLIES PER: X POLICY 0. PRLOC PRODUCTS-COMP/OP AGO $ 1,000,00 E A AUTOMOBILE LIABILITY ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS HIRED AUTOS X NOWOWNED AUTOS 5068708038 06/30/12 06/30/13 COMBINED SINGLE LIMIT Ea accident) 1,000,00 BODILY INJURY (Per person) $ X BODILY INJURY(Peraccitlent) 1 X PROPERTY DAMAGE a Per eccierrt y S A B J( UMBRELLA LIAR EXCESS LIAR X OCCUR CLAWS -MADE NIA 5237063442 4061859 06/30/12 10/01/12 06130/13 10/01/13 EACH OCCURRENCE S 4,000,00 AGGREGATE s 4,000,00 DIEDRETENTION WORKERSCOMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETORIPARTNER/EXECUTNE YIN OFFICERMIEMBER EXCLUDED? ❑ (Mandatory in NH) M yes describe under DESCRIPTION OF OPERATIONS below WC STATU. OTH- S E.L. EACH ACCIDENT $ SOO,OO E.L. DISEASE - EA EMPLOYEE f 500,00 E.L. DISEASE - POLICY LIMIT S 500,00 DESCRIPTION OF OPERATIONS / LOCATIONS) VEHICLES (Attach ACORD701,Additional Remarks Schedule,ifmoresp eisrequired) !`COTICIf`II TL u�r ncn 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. AUTHORRED REPRESENTATIVE Tim Gries ©1988-2010 ACORD CORPORATION. All rights reserved. __ ,_.........I I lie AvuRu name ana logo are registered marks of ACORD