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HomeMy WebLinkAbout480231 SECOND WAVE AUTOMOTIVE CARE INC - INSURANCE CERTIFICATE (2)A`� �® CERTIFICATE OF LIABILITY INSURANCE 7/117/20112 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 endomement(s). PRODUCER CO West Insurance Group PO Box 910 1 Castle ROCK `!`r-v� CO 80104 CONTACT COWeet Corporate NAME: rP PHONEFail. (303) 688-9597 FAX Net (303)688-8858 E-MAIL .info@coarest. core INSURERS AFFORDING COVERAGE NAIC s INSURER A:Colorado Casualty Insurance Cc 20621 INSURED Second Wave Automotive Care, INC 1921 S Alma School Road Ste 110 Mesa AZ 85210 INSURERS Peerless Indemnity 18333 INSURER CPlnnacol Assurance 41190 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:Master 12/13 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 ADDL SUBR POLICYNUMBER POLICY EFF MMIDDNYYY) POLICY EXP fMMIDDNYYY1 LIMITS GENERALLIABILITY EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED PREMISES fEa occurrence S 100,000 A CLAIMS -MADE OCCUR BP8706320 /28/2012 /28/2013 MED EXP (Any me person) $ 15,000 PERSONAL B ADV INJURY $ 1,000,000 GENERAL AGGREGATE It 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMPIOP AGG $ 2,000,000 $ X POLICY PRO LOC AUTO MOBILE LIABILITY EaMaccderDN S INGLE LIMIT 1,000,000 BODILY INJURY (Per person) $ A ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS BP8706320 /28/2012 /28/2013 BODILY INJURY (Per accident) $ X DAMAGE Per accident $ NONOWNEDPROPERTY HIRED AUTOS M AUTOS $ X UMBRELLA LIAR OCCUR EACH OCCURRENCE It 1,000,000 AGGREGATE It 1,000,000 B EXCESS LIAR CLAIMS -MADE DED I X I RETENTION$ 10,00 $ U8706520 /28/2012 /28/2013 C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y I N ANY PROPRIETORIPARTNERIEXECUTIVE OFFICERNEMBER EXCLUDED? (Mandatory in NH) NIA 129995 /1/2012 /1/2012 xI WC STATU- OTH- I TORY[ WITS ER E.L. EACH ACCIDENT $ 100,000 E.L. DISEASE - EA EMPLOYE $ 100,000 If ns, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT 1 $ 500,00 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, 8 more space is required) City of Fort Collins PO Box 580 Fort Collins, CO 80522 r Le1c1 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 ACORD 25 (2010105) Madron/SLB r-1�� ©1988-2010 ACORD CORPORATION. All rights reserved. INS025 (201005).Ol The ACORD name and logo are registered marks of ACORD