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HomeMy WebLinkAbout125353 SAFE SYSTEMS INC - INSURANCE CERTIFICATE (8)OP ID: KC 1A�� CERTIFICATE OF LIABILITY INSURANCE OAT10/010/YYYY) lo/ovlz 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 endorsements . - PRODUCER 877.242.9600 Insurance Agency, Inc. 93 East Main Street 877-243-8995 93 EasCentrat MinStreet Smithtown, NY 11787 Allce Giacalone y-� y 1 U, CONTACT - - — NAME: PHONE FAX - AIC No E-MAIL ADDRESS: PRODUCER SAFES-4 CUSTOMER ID . INSURER(S) AFFORDING COVERAGE NAIC tl INSURED Safe Systems, Inc. 421 S.Pierce Avenue Louisville, CO 80027 INSURERA:First Mercury Insurance Co. 10657 INSURER B:Scottsdale Insurance Company 41297 INsuRERc:Hartford Casualty Insurance Co 29424 INSURER D: Scottsdale Indemnity Company 15580 INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: 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 O POLICY NUMBER MM/DDY EFY MMPOLICYEXP IYYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 PREMISES Ea occ.me.cel $ 50,00 A X COMMERCUYGENERALUABIUTY CLAIMS -MADE � OCCUR SE-CGL-0000018371-01 10101112 10/01113 MED EXP(My one persor) $ 5,00 PERSONAL B ADV INJURY s 1,000,00 X Errom&Omissions X I Contractual Liab GENERAL AGGREGATE $ 2,000,00 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS -COMROP AGG $ 2,000,00 X POLICY PRO- LOC $ C AUTOMOBILE LIABILITY ANrnuTo - ALL OWNED AUTOS 12UUN OJ9582 10101/12 10I01113 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,00 BODILY INJURY(Pa peaon) $ BODILY INJURY (Per accident) $ I SCHEDULED AUTOS HIRED AUTOS PROPERTY DAMAGE (Per accident$ NONOWNEDAUTOS $ UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 8,000,00 AGGREGATE $ 8,000,00 e X EXCESS LIAB CLAIMS -MADE xLs0084841 10101112 1n/ov,3 ueoucTleLe $ $ RETENTION $ WORKERS COMPENSATION WC STATU- T1- AND EMPLOYERS' LIABILITY YIN ANY PROPRIETORIPARTNER/EXECURVE OFFICERIMEMBER EXCLUDED? ❑NIA E. L EACH ACCIDENT $ E.L DISEASE - EAEMPLOYE $ (Mandatory In NH) tl yes, desvibe under DE SCRIPTION OF OPERATIONS be. E.L DISEASE -POLICY LIMIT $ C Commercial Prop 12UUN OJ9582 10101112 10101113 SEE POLIO D EPL EK13075545 10/01/12 10101/13 EEC/AGG 1,000,00 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (Attach ACORD 101, Addldonal Remarks Schedule, If more space Is required) As pertains to the insureds operations as required by written contract. FORTCO2 City of Fort Collins P.O. Box 580 Fort Collins, CO 80522 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 ©1988.2009 ACORD CORPORATION. All dahts reserved ACORD 25 (2009109) The ACORD name and logo are registered marks of ACORD OP ID: GL ,44coRo CERTIFICATE OF LIABILITY INSURANCE DAT10103DrrYYY) 10/03/12 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 877-242-9600 Central Insurance Agency, Inc. g77-243-8995 93 East Main Street Smithtown, NY 11787 Alice Giacalone CONTACT PNONE FAX A/C No E,d : I INC, No): E-MAIL ADDRESS: PRODUCER CUSTOMER lD d: SAFES INSURERS AFFORDING COVERAGE NAIC If INSURED Safe Systems, Inc. 421 S. Pierce Avenue Louisville, CO80027 INSURER A: First Mercury Insurance Co. 10657 INSURER B: Scottsdale Insurance Company 41297 INSURER C: Hartford CasualtyInsurance Co 29424 INSURER D:Scottsdale Indemnity Company.15580 INSURER E : INSURER F COVERAGES CERTIFICATE NUMBER: 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 AODL UBFF POLICY NUMBER MOUC YEYYY POLICYMMIDDfYYYY LIMITSITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE IX I OCCUR X Errors&Omissions SE-CGL-0000018371-01 10101112 10101/13 EACH OCCURRENCE $ 1,000,00 PREMISES Ea occunarcal $ 50,00 MED EXP (My one Person) $ 5,00 PERSONAL B ADV INJURY $ 1,000,00 X Contractual Liab GENERAL AGGREGATE $ 2,000,00 GENT AGGREGATE LIMIT APPLIES PER. X POLICY PRO LOC PRODUCTS - COMP/OP AGG $ 2,000,00 $ C AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS 12UUN OJ9582 10/01/12 10/01/13 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,00 X BODILY INJURY (Per person) $ X BODILY INJURY (Per accident) $ X PROPERTY DAMAGE (Peraccidenl) $ X $ .B_. UMBRELLA LIAB EXCESS UAB X OCCUR CLAIMS -MADE XLS0084841.. _ 10/01/12 10/01/13 EACH OCCURRENCE $ 8,000,00 X AGGREGATE $ 8,000,00 _ _ __ _ DEDUCTIBLE RETENTION $ $ $ WORKERS COMPENSATION AND EMPLOYERS LIABILITY Y/ N ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ OFFICERIMEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N/A STATU- OTH- TOR EL EACH ACCIDENT $ E.L. DISEASE -EA EMPLOYEE $ E.L. DISEASE -POLICY LIMIT $ D EPL EK13075645 10/01/12 10/01/13 EEC/AGG 1,000,00 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more apace Is reclulred) As pertains to the insureds operations as required by written contract CERTIFICATE HOLDER CANCELLATION FORTCO2 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Fort Collins ACCORDANCE WITH THE POLICY PROVISIONS. P.O. Box 580 AUTHORIZED REPRESENTATIVE Fort Collins, CO 80522 14111tsr/1 -- - - ©1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009/09) The ACORD name and logo are registered marks of ACORD