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Home My WebLink AboutWESTERN ROUTING SERVICES LLC - INSURANCE CERTIFICATEACORD CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYYI 09/13/2012 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 endorsemenl(s). PRODUCER CONTACT NAME: Rene' Larricq Leavitt Group Four Corners Pa"Ic°Neia Eat: 970. 2 59. 7966 ac Nq:970.259.4915 72 Suttle Street ADDRSS: rene-larricq@leavitt.com Suite L PRODUCER 00010940 CUSTOMER ID INSURER(S) AFFORDING COVERAGE NAIC0 Durango, CO 81303 INSURED INSURER A: Mountain States Ins Group 14648 Western Routing Services, LLC INSURER B: Pinnacol Assurance 41190 INSURER C: PO BOX 1808 INSURER D: Evergreen, CO 80439 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 12-13 GL AL WC 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 ADD INSR SUER AVID POLICY NUMBER POLICY EFF MMIDDIYYYY POLICY EXP MMIDDIYYYY LIMITS A GENERAL LIABILITY X COMMERCIAL GENERALLIABILITY CLAIMS -MADE R�OCCUR CPP01304450 07/18/2012 07/18/2013 EACHOCCURRENCE $ 1,000,00 PREMISES Ea coca ante S 100,00 MED EXP(Any we person) $ 10,000 PERSONAL BADVINJURY $ 1,000,00 GENERAL AGGREGATE $ 2,000,00 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO- ECT OC PRODUCTS - COMP/OP AGG $ 2,000,00 S A AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULEDAUTOS HIREDAUTOS NON -OWNED AUTOS BAP01304450 07/18/2012 07/18/2013 COMBINED SINGLE LIMIT (Ea awident) S 1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ X PROPERTY DAMAGE (Per accident) $ X X $ $ UMBRELLA LIAR EXCESS LIAR OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DEDUCTIBLE RETENTION $ $ $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY OFFICERMEIMBEER EXCLUDED?ECUTIVE❑ (Mandatory in NH) IfY descnb under DESCRIPTION OF OPERATIONS Oelow NIA 412614 01/04/2012 05/04/2013 X WCSTAru- OTH- TORY LIMITS ER E. L. EACH ACCIDENT 8 SOD, OO E. L. DISEASE - EA EMPLOYEE $ 500,00 E.L.DISEASE- POLICY LIMIT $ 500,00 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (AUach ACORD 101, Additional Remarks Schedule! if more apace Is required) ity of Fort Collins is named Additional Insured as respects General Liability where required by ritten contract CERTIFICATE HOLDER CANCELLATION FAX: 970.221.6707 City of Fort Collins Purchasing Department Attn: John Stephen 215 N Mason 2nd floor Ft., Collins, CO 80524 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 Rene' Larri iFI:I:bbUkL•CK�7:7aZKU:73�7:7ari[Q: �_\I�7CIr'S�7��- .f-S.'1 ACORD 26 (2009/09) The ACORD name and logo are registered marks of ACORD