No preview available
HomeMy WebLinkAbout159569 PS INSTALLATION INC - INSURANCE CERTIFICATEFrom: FAXmaker To: CITY'S DIRECTOR OF PURCHASING AND RISK MANAGEMENT Page: 212 Date: 10/512012 12:06:43 PM AgIll a" CERTIFICATE OF LIABILITY INSURANCE —DATE o5,2DD 2 " 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(les) 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 Doug Jones c/o Arlex Risk Solutions, Inc. 6800 E. Chaparral Rd, Suite 230 Scottsdale, AZ 85250 NAME: PNGNE FAX EXt : 480 951-4177 kc me): 490 951-4266 E-M IL ADDRESS: INSU RERIS) AFFOR DING COVERAGE NAICY I INSURER A: American Zurich Insurance Company 40142 Up WSURER INSURER B Oasis Acquistion, Inc All. ErTp: P.S. Installations Inc. 2054 Vista Parkway Suite 300 INSURER c: West Palm Beach, FL 33411 INSURER D: INSURER E INSURER F : COVERAGES CERTIFICATE NUMBER: 12FLO75826400 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. NSR LTR TYPE OF INSURANCEADDLE SR D POLICY NUMBER POLICY EFF MMND� PODCY IXP MMYD I LIMRIS GENERAL UABEEE( EACH OCCURRENCE Is PREMISES Ea emurrmcel Is COMMERCIAL GENE RAL LIABILRY CLAIMS -MADE F—IOCCUR Anymeperson) 5 PERSONAL INJURY $ AGGREGATE $ GEN1 AGGRF.GATF. LIMN APPLIESPER: -COMPOPAGG WRY $ POLICY PRO LOC $ AUTOMOBILE LIABIIJTY COMBINED SINGLE LMN JURY ire, person) $ ANY AUTO AILOWNED SCHEDULEDJURY('XI AUTOS AUTOS acideip $ HIRED AUTOS NONOWNEU AUTOS PROPERTY DAMAGE Per accconl $ UMBRELLA LIAB OCCUR EACH OCCURRENCE S AGGREGATE $ EXCESS LIAB CLAIMS MADE DES RETENTION$ $ WORKERS COMPENSATION AND EMPLOYERS'LIABILITY YIN ANYPROPRETOR•PARTNER"EXECUTIVE OFFICER%MEMBER EXCLUDED? ❑ NIA WC 29-38-687-10 06/01/2012 06/01/2013 X OT - ER F.L. EACH ACCIDENT $ 1,000,000 EL. DISEASEEAEMPLOYEE $ 1,000,000 PJaMaiery In NN) tt yas deecr be under DESCRIPT ION OF OP E RATIONS below EL.DISEASE - POLICY LIMB $ 1,000,000 Location Coverage Period: 06/01/2012 06/0112013 Client# 9516-CO-MAIN DESC IONOFOPEMTIONSILOCATIONSIVEHICLES IAtUch ACORD101,Addlllomi Remarks SchWulo,Ifmaespecelsregulmdl P.S. Installations, Inc. FORT COLLINS MUSEUM OF DISCOVERY Coverage is provided for 3857 Steele St Ste C only those employees Denver, C080205 leased to but not sulownlractols of: CITY'S DIRECTOR OF PURCHASING AND RISK I SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE MANAGEMENT THE EXPIRATION DATE THEREOF, NOTICE VALL BE DELIVERED IN PO BOX 590 ACCORDANCE WITH THE POLICY PROVISIONS. FORT COLLINS, CO B0522 © 1988-2010 ACORD CORPORATION. All This fax was sent with GFI FAXmaker fax server. For more information, visit: http://www.gfi.com A 14lJKLl CERTIFICATE OF LIABILITY INSURANCE 10/8/0/8/MfD2012 THIS CERTIFICATE IS ISSUED AS A ivIARER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE MOLDER 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 tho certtlic de holder is an ADDITIONAL INSURED, the policy(les) must be endorsed. If SUBROGATION IS WAIVEp, subJect to the }arms and Conditions of the policy, certain Policies may MQUire an Andomomant. A Statement on this CertlRcata does certificatenot center rights to the holder in lieu of Such andomemam(s) CO -PRO GROUP INC PHONE? E ' 5601 S BROADWAY 9350 ADDRESS: LITTLETON, CO 80121 9URE0 INSURER A PS INSTALLATIONS, INC. AND INSURERS: SHELF IMAGE INC INSURER C: 3857 STEELE ST UNIT C INSURERO DENVER, CO 80205 - -- - - - •••- • ��,..�=.. v1 i11 u� 11 uaI¢U BELOW HAVE BEEN ISSUED INDICATED. NOTWITHSTANDING ANY REQUIREMENT. TERM OR CONDITION OF ANY CONTRAC CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLIO EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY R TYPE OF INSURANCE OB<t IxaR vryR POLICY NUMBER pm GBNERAL LIABILITY X coMMERCIAL GENERlLL Luagm CWM51dAOE a OCCUR TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD T OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS IE$ DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, Dem ry ea.c CBP8866177 08/17/12 LIMITS EACH OCCURRENCE g 1,000 PREMISES Eeamu+Pnce S 100 MEDEXP(Arv,ormpmsen) Is 15 7/13 1 PERSONAL& ADVIIWNRv It I 666 REGATE LMJT APPLIES PER;Y trveKAL AGGREGATE 9 X JE0. LOC PRODUCTS• COMPIS AGO $LE LIABILITYSTO Ea acddeN $NED SCHEDULED BA8867677 V 08/17/13 BODILY INJURY(Rw mom) $ h08/17/12 AUT08 ED X BODILY IN.IURY IPer ecddgnt) SAUi05 ALTOS X SPECIFIED PPr acaoem §LUI LIAB X OCCUR §9 LLAB I CU8869177 CLARAS•MADE 08/17/19 EACH OCCURRENCE § AND EMPLOYERS LIABILITY Yre ANY PBCRwEmR/PgmNERt]@wnYa OFPICER WSER E%CLLpEay UI N/A msndMM In NHI AI CARGO COVERAGE CBP0866177 u=KIHr10N OF OPERATION$1 LOCATIONS VEHICLES (AL'Ed, ACORD MI gddilim,: Rarlwks Sthedub, if more ARTISTIC STORAGE IS NAMED AS ADDITIONAL INSURED ARTISTIC STORAGE 2479 N LARRABEE ST UNIT C CHICAGO, IL 60610 ATTN: SUSAN WINTER AUGREGATE s 5, 000, 000 § AT y TORY IMITS DE E.L. EACH ACCIDENT § EL. DISEASE -EA EMPLOYE i E L. DISEASE -POLICY LIMIT § 7/1 $$500,000 PER LOAD SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WR'H THE POLICY PROVISIONS. NI ICOR025(20101o5) The ACORD name and logo are registered marks of ACORD .AC.VRD CORPORATION. All rights reserved,