The URL can be used to link to this page

Home My WebLink AboutCHAMPION WINDOW CO OF FORT COLLINS LLC - INSURANCE CERTIFICATECHAMPIO-01 KMULLINS A16. R CERTIFICATE OF LIABILITY INSURANCE D12/131201ATE YY) 12/13/2012 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 endorsement(s). PRODUCER Neace Lukens - Dayton/ Assured NL Insurance Agency Inc 6651 Centerville Business Pkwy Da ton, OH 45459 Y CONTACT Karen Mullins PHONE FAX ANC, No Ext): (937 ) 435-4788 (A/c,±�O: (937) 435-7395 EMAIL ADDRESS: karen.mullins@neacelukens.com INSURER(S) AFFORDING COVERAGE NAIC p INSURER A: American Fire & Casualty 24066 INSURED INSURER B: Indiana Insurance Company 22659 Champion Opco, LLC Champion Window Co. of Ft. Collins, LLC 5850 Byrd Drive INSURER C INSURER D INSURER E: Loveland, CO 80538 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. NOTVVITHSTANDING 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 ADDL INSR _ SUER WVD POLICY NUMBER POLICY EFF ( POLIC YVVY) POLICY EXP MMIDDIYYYY LIMITS A _ GENERAL LIABILITY FxICOMMERCIAL GENERAL LIABILITY CLAIMS -MADE L" I OCCUR BKA55279295 12/1/2012 12/1/2013 EACH OCCURRENCE $ 1,000,000 PREM$ SGEaEowurtence)_ $ 100,000 MED EXP (Any one parson) $ 10,000 PERSONAL B ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,0001 GEN'L AGGREGATE LIMIT APPLIES PER POLICY PRO- XJ LOC JECT PRODUCTS - COMP/OP AGG $ 2,000,000 $ A AUTOMOBILE LIABILITY ANY AUTO ALL OVMED SCHEDULED AUTOS AUTOS HIRED AUTOS NON -OWNED AUTOS BAA55279295 12/1/2012 12/1/2013 CO BINEDd.nI SINGLE LIMIT $ 1,000,000 X7 BODILY INJURY (Per person) $ BODILY INJURY Par accident) ( ) $ PROPERTY DAMAGE (Per accident $ B JL I�—{11 UMBRELLA LIAB EXCESS UAB 1XI OCCUR CLAIMS -MADE US055279295 12/1/2012 12/1/2013 EACH OCCURRENCE $ 10,000,000 AGGREGATE $ 10,000,000 DED I X I RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOWPARTNEWEXECUTIVE OFFICEWMEMBER EXCLUDED? (Mandatory in NH) II yes, dascrihe under DESCRIPTION OF OPERATIONS oekxv N / A VIC STATU- OTH- TQF LIMBS ER $ E.L. EACH ACCIDENT E.L. DISEASE -EA EMPLOYEE $ E L DISEASE -POLICY LIMT $ DESCRIPTION OF OPERATIONS I LOCATIONS VEHICLES (Attach ACORD 101, Additional Remarks Schedule, H more space Is required) City of Ft 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 Y e A-_ t_ . r-?cU CfC 0 ACORD CORPORATION. All rights reserved. ea Utcu co Icu IVIUO) I he ACORD name and logo are registered marks of ACORD