HomeMy WebLinkAboutWALKER MANUFACTURING CO - INSURANCE CERTIFICATEClient#: 20651
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ACORD. CERTIFICATE OF LIABILITY INSURANCE
DATE(MM/DDIYYYY)
09/2812012
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 endorsement(s).
PRODUCER
Flood & Peterson lns.,Inc.
P. O. Box 578
Greeley, CO 80632
970 356-0123
CONTACT NAME: Kelly Beauvais
PHONE g70 266.7121 970 50
A/C No Ext: A/C, No: 6-6846
E-MAIL Kell Beauvais floodand eterson.com
ADDRESS: Y P
CUSTOMER ID#:
INSURER(S) AFFORDING COVERAGE
NAIL #
INSURED
---� Walker Manufacturing Co.
5925 East Harmony Road
Fort Collins, CO 80528
INSURER A: The Hartford Insurance
INSURER B Pinnacol Assurance
INSURER C
INSURER D
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 REOUIREMENT, 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.
R
LPOLICY
TYPE OF INSURANCE
DDL
UBR
POLICY NUMBER
MIDDIY
POLICY
I DDNYYY
LIMITS
A
GENERAL LIABILITY
X COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE F7xOCCUR
X $100,000 SIR
34ECSOF1729
9/3012012
09130/201
EACH OCCURRENCE
S1 000000
PREMISES Ea� ence�
s300OOO
MOD EXP(An,om, ,sen)
sExcluded
PERSONAL B ADV INJURY
$1,000,000
GENERAL AGGREGATE
$2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER.
X POLICY X PRO- LOC
PRODUCTS - COMP/OP AGG
s2,000,000
$
A
AUTOMOBILE
LIABILITY
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
AUTOS
NON -OWNED AUTOS
34UUNNJO856
9/3012012
09/30/2013
COMBINED SINGLE LIMIT
(Ea accident)
s1,000,000
BODILY INJURY(Per person)
$
BODILY INJURY (Per accident)
$
1XX
PROPERTY DAMAGEHIRED
(Per accident)$
S
$
UMBRELLA LIAB
EXCESS LIAB
OCCUR
CLAIMS -MADE
EACH OCCURRENCE
S
AGGREGATE
S
DEDUCTIBLE
RETENTION
s
$
B
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITYER
ANY PROPRIETORIPARTNERIEXECUTIVEYIN
OFFICER/MEMBER EXCLUDED?
(Myandatory in NH)
If DESCRIPTION OF OPERATIONS below
NIA
2270632
4/01/2012
04/01/2013
X WCST`jMI OTH
E.L. EACH ACCIDENT
$500,000
E.L. DISEASE - EA EMPLOYEE
S$500,000
E.L. DISEASE - POLICY LIMIT
sSOO,000
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required)
Certificate Holder is Additional Insured as their interests may appear
regarding land leased at:
Loc# 2 - 5244 Cessna Drive; Loveland, CO
City Manager
City of Ft. Collins
300 LaPorte Avenue
Fort Collins, CO 80521
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
01988-2009 ACORD CORPORATION. All rights reserved.
ACORD 25 (2009/09) 1 Of 1
#S7389251M738921
The ACORD name and logo are registered marks of ACORD
KLB