HomeMy WebLinkAbout122004 SHAMROCK TAXI OF FORT COLLINS - INSURANCE CERTIFICATEACOR," CERTIFICATE OF LIABILITY INSURANCE
DATE 2012 YYYY)
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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
CONTACT
NAME:
'Marsh USA, Inc.
PHONE FAX
Two Logan Square
No:
E-MAIL
ADDRESS:
Philadelphia, PA 19103
AM: veolia.certrequest@mmh.com 1212.948.5053
INSURERS AFFORDING COVERAGE
NAIC p
INSURER A: Old Republic Insurance Cc
24147
390631-Buck3-All-I2-13 '\ �'ZO.� lL
INSURED
Shamrock Taxi of Fort Collins, Inc.
INSURER B: NIA
WA
INSURER C: N/A
NIA
4414 East Harmony#200
INSURER D
Pon Collins, CO 80528
INSURER E :
INSURER F :
COVERAGES CERTIFICATE NUMBER: CLE-003705662-07 REVISION NUMBER:3
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED'.'^ 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
AODI-TYPEOFINSURANCE INS&SUER
POLICY NUMBER
MM POLICY EFF
/DDYYYYI
POLICY EXP
(MMUDD/YYYYJ
UNITS
GENERAL LIABILITY
EACH OCCURRENCE
$
DAMA T RENT D
COMMERCIAL GENERAL LIABILITY
PREMISES Ea oo msmcc
$
CLAIMS -MADE OCCUR
MED EXP (My one person)
$
PERSONAL a ADV INJURY
$
GENERAL AGGREGATE
$
GEN'L AGGREGATE LIMIT APPLIES PER:
PRODUCTS - COMP/OP AGG
$
1-1 POLICY PRO- LCC
IFCT
$
A
AUTOMOBILE
LIABILITY
MWTB21267
07/01/2012
07/0112013
COMBINED SINGLE LIMIT
Ea accident
500,000
X
BODILY INJURY (Per person)
$
A
ANY AUTO
MWZX26684
0710112012
0710112013
ALL OWNED SCHEDULED
AUTOS AUTOS
BODILY INJURY (Per accident)
$
PROPERTY DAMAGE
Per aocWent
$
NON -OWNED
HIRED AUTOS AUTOS
$
UMBRELLA LIAR
OCCUR
EACH OCCURRENCE
$
AGGREGATE
$
EXCESS LIAB
CLAIMS MADE
DIED RETENTION$
$
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY YIN
WC STATU- I OTH-
offyiMITS ER
E.L. EACH ACCIDENT
$
ANY PROPRIETORIPARTNERIEXECUTIVE❑
OFFICERIMEMBER EXCLUDED?
N/A
(Mandatory in NH)
E.L. DISEASE - EA EMPLOYE
$
If yes, describe under
DESCRIPTION OF OPERATIONS below
E.L. DISEASE -POLICY LIMIT
$
DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (Attach ACORD 101. Additional Remarks Schedule, If mom apace Is required)
Location Code: CCC
GLeJalgaLl
Dial -A -Ride
6570 Fortner Or
Ft. Collins, CO 80525
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
of Mann USA Inc.
Manashi Mukherjee _%LauQow
1988-2010 ACORD CORPORATION- All rights reserved
ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD