HomeMy WebLinkAbout487950 MAC BESTOS INC - INSURANCE CERTIFICATEA`� �® CERTIFICATE OF LIABILITY INSURANCE
9/5/2012 "'
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 endorsements).
PRODUCER
Co West Insurance Group
PO. Box 910
Castle Rock CO 80104
CONTACT COWest Corporate
NAME: rP
PHONE (303)688-9597 FAX (303)688-8858
ADDRESS. info@ cowest. com
INSURERS AFFORDING COVERAGE
NAIC p
INSURER A:Endurance American Specialty
INSURED ` SD
Mac Bestos, Inc. �" ��i
1235 Delaware cut.
Denver CO 80204
INSURERS Owners Ins CO
32700
INSURERC:
INSURER D:
INSURER E
INSURER F:
COVERAGES CERTIFICATE NUMBER:12-13 MASTER CERT 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
POLICYNUMBER
MMIICYEFF
POLICYM/OEXP
LIMITS
GENERAL LIABILITY
EACH OCCURRENCE
$ 1,000,000
A
}{ COMMERCIAL GENERAL LIABILITY
CI -AIMS -MADE OCCUR
CC101015125-00
/1/2012
/1/2013
DAMAGE TO RENTED
PREMISES Ea occurrence
$ 300,000
MED EXP(Any one Perron)
$- 25,000
PERSONAL B ADV INJURY
$ 1,000,000
GENERAL AGGREGATE
$ 2,000,000
GENT AGGREGATE
LIMIT APPLIES PER:
PRODUCTS - COMP/OP AGG
$ 2,000,000
POLICY
X PRO LOC
$
MOBILE LIABILITY
COMBINED SINGLE LIMITEa cdern
1 000 000
INJURY(Per person)
$
NYAUTOBODILY
OWNED SCHEDULED
UTOSAUTOS
896304900
0/1/2012
0/1/2013
RALL
BODILY INJURY(Per accident)
$
PROPERTY DAMAGE$
Per accident
NON-OVMED
IRED AUTOS AUTOS
Uninsured motorist Ell s IA limit
$ 11000,0001
X
UMBRELLA LIAB
X
OCCUR
EACH OCCURRENCE
$ 3,000,000
AGGREGATE
$ 3,000,000
A
EXCESS LIAB
CLAIMS -MADE
DELI I X. I RETENTION$ 10,00C
$
FXS101015126-00
/l/2012
/1/2013
WORK ERS COMPENSATION
WC STATU- DTH-
AND EMPLOYERS' LIABILITY Y / N
ANY PROPRIETORIPARTNERIEXECUTIVE
OFFICER/MEMBER EXCLUDED?
NIA
E.L. EACH ACCIDENT
$
E.L. DISEASE - EA EMPLOYE
$
(Mandatory in NH)
If yes, describe under
DESCRIPTION OF OPERATIONS below
E.L. DISEASE - POLICY LIMIT
$
A
PROFESSIONAL LIABILITY
CC101015125-00 Claims
/1/2012
/1/2013
CONTRACTORS& $1,000,000
POLLUTION 6 MOLD LIAB.
de/Retro date 9-1-03
ASBESTOS ABATEMENT $2,000,000
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, AddiOonal Remarks Schedule, if more apace Is required)
PROJECT: LINCOLN CENTER ASBESTOS ABATEMENT. CERTIFICATE HOLDER IS NAMED AS AN ADDITIONAL INSURED AS
RESPECTS INSURED'S GENERAL LIABILITY COVERAGE - BLANKET ADDITIONAL INSURED ENDORSEMENT.
CITY OF FORT COLLINS
ATTN: PURCHASING DEPARTMENT
215 N. MASON
2ND FLOOR
FORT 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
ACORD 25 (20101051
Meyers/AJM
19ER-2010 ACORD CORPORATION. All rinhts raearuad
INS025(201005).01 The ACORD name and logo are registered marks of ACORD