HomeMy WebLinkAbout245369 PREMIER FIRE PROTECTION INC - INSURANCE CERTIFICATE (2)Client#: 44470
PREFI
ACORDTn CERTIFICATE OF LIABILITY INSURANCE
D;T/a4;2o;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(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 Ins., Inc.
P. O. Box 578
Greeley, CO 80632
970356-0123
CONTACT NAME: Sandie Chellson
PHONENo Xt g70 356-0123 FAX
ac E: aC, No : 9705066836
ADDRESS: schellson@floodpeterson.com
PRODUCER
CUSTOMER ID C
INSURER(S) AFFORDING COVERAGE
NAICIf
INSURED
Premier Fire Protection Inc.
630 West 1st Street
INSURER A: Gotham Insurance Company
25569
INSURER BPinnacol Assurance
an
The Cincinnati Insurance Com an
INSURER C : Comp
10677
CO 80537
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 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
TYPE OF INSURANCE
ODL
UD
POLICY NUMBER
EFF
MWDDNYV
POLICY P
MWDD/YYCY
LIMITS
A
GENERAL LIABILITY
X COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE FxIOCCUR
X BI/PD Ded:5,000
GL2012FSCO0118
12/04/201212/04/201
EACH OCCURRENCE
$1000000
PRE' MG
SES Eao�currDence
$100 000
MEDEXP(Anyoneperson)
$S,000
PERSONAL&ADV INJURY
S1,000,000
GENERAL AGGREGATE
$2,000,000
GEN'L AGGREGATE
POLICY
LIMIT APPLIES PER:
PHI- FCT n LOL
PRODUCTS - COMP/OP AGG
52,000,000
$
C
AUTOMOBILE
LIABILITY
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIREDAUTOS
NON -OWNED AUTOS
ENP0162935
12/04/2012
12/04/2013
COMBINED SINGLE LIMIT
(Ea accident)
$1 000000
BODILY INJURY (Per person)
$
BODILY INJURY (Par accitlent)
$
X
X
PROPERTY DAMAGE
(Per accident)
$
X
$
$
A
X
UMBRELLA LAB
EXCESS LIAB
X
OCCUR
CLAIMS -MADE
UM2012FSC00044
12/04/2012
12104/2013
EACH OCCURRENCE
$5000,000
AGGREGATE
s5,000,000
X
DEDUCTIBLE
RETENTION 10000
$
$
B
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY
ANY PROPRIETOR/PARTNER/EXECUTIVEV/N
OFFICERIMEMBER EXCLUDED?
(Mandatory in NH)
If yes, describe under
DESCRIPTION OF OPERATIONS below
NIA
4064028
12/01/2012
12/01/201
X WCSTATU- OTH
ER
E.L. EACH ACCIDENT
$1000000
E.L. DISEASEEAEMPLOYEE
$1,000,000
EL.DISEASE - POLICY LIMIT
$1000000
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more apace is required)
City of Fort Collins
PO Box 580
Fort Collins, CO 80522-0580
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
#S750137/M750099
The ACORD name and logo are registered marks of ACORD
SXC