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YENTER COMPANIES INC - INSURANCE CERTIFICATE
12/21/2012 9:36:17 AM PST (GMT-8) FROM: 100005-TO: 19702216707 From: Texas AGA, Inc. 5950 Sherry Lane, Suite 500 Dallas, TX 75225 Yk 800-875-9484 Ext. 308 972-980-9481 w .aga-us.com _ From: To: City of Fort Collins Director of Purchasing & Risk Manage John Stephen/Jan P.O. Box 580 Ft. Collins CO 80522 Subject: Date: Delivery Via No. of Pages Page: 1 of 2 FAX DOCUMENT Certificate of Insurance Delivery by acertsonline TM (AGA DAL) Jana Burchfield 12/21 /2012 FAX 19702216707 THIS MESSAGE IS INTENDED FOR THE USE OF THE INDIVIDUAL OR ENTITY TO WHICH IT IS ADDRESSED AND MAY CONTAIN INFORMATION THAT IS PRIVILEGED, CONFIDENTIAL AND EXEMPT FROM DISCLOSURE UNDER APPLICAB LE LAW. IF THE READER OF THE MESSAGE IS NOT THE INTENDED RECIPIENT, OR THE EMPLOYEE OR AGENT RESPONSIBLE FOR DELVE RING THE MESSAGE TO THE INTENDED RECIPIENT, YOU ARE HEREBY NOTIFIED THAT ANY DISSEMINATION, DISTRIBUTION OR COPYING OF THIS COMMUNICATION IS STRICTLY PROHIBITED. IF YOU HAVE RECE NED THIS COMMUNICATION IN ERROR, PLEASE NOTIFY US IMEDIATELY BYTELEPH ONE, AND RETURN THE ORIGINAL MESSAGE TO US AT THE ABOVE ADDRESS VIA REGULAR POSTAL SERVICE. © 2002 Certificate of Insurance Delivered by acertsonline TM Insurance Visions, Inc. All rights reserved. 12/21/2012 9:36:17 AM PST (GMT-8) FROM: 100005-TO: 19702216707 Page: 2 of 2 A L7® CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DDnrrr) 12112012 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 Texas AGA, Inc. 5950 Sherry Lane, Suite 500 Dallas, TX 75225 CONTACT NAME: AGA DAL Jana Burchfield PHONE A/c No Eau 800-875-9484 Ext. 308 FAX A/c No: 972-980-9481 E-MAILADDRESS 'burchfield a a-us.com INSURERS) AFFORDING COVERAGE NAIC# INSURERA: www.aga-us. corn INSURED Yenter Companies, Inc. 20300 W. Hwy 72 INSURERS INSURERC: INSURER D Arvada, CO 80007 NSURERE: NSURERF: COVERAGES CERTIFICATE NUMBER- in;nAP nd 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 ADDL INSR SUBR MD POLICY NUMBER POLICY EFF MMIDD/YYYY POLICY EXP MMIDD/YYYY LIMITS a GENERALLIABILITY GL80307610 12/31/2012 12/31/2013 EACH OCCURRENCE $ 1,000,000 J COMMERCIAL GENERAL LIABILITY PREMISES Ea RENTED $ 100,000 CLAIMS -MADE OCCUR MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 J Blasters Liability GENERAL AGGREGATE $ 2,000,000 GEN'LAGGREGATE LIMITAPPLIES PER. PRODUCTS - COMP/OP AGO $ 2,000,000 POLICY J PRO- JECTLOC $ x AUTOMOBILE LIABILITY BA80307510 12/31/2012 12/31/2013 COMBINED SINGLE LIMIT (Ea accidenp $ 1,000,000 J BODILY INJURY (Per person) $ ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOSNON-O BODILY INJURY (Per accident) $ PROPERTY Ron $ HIRED AUTOS AUTOS $ A UMBRELLA LIAB OCCUR XS80307710 12/31/2012 12/31/2013 EACH OCCURRENCE $ 5000000 AGGREGATE $ 5,000,000 EXCESS LIAB CLAIMS -MADE DED RETENTION$ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN WC STATU- (1TH- TORV LIMITS ER E.L. EACH ACCIDENT $ ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? ❑ N/A EL DISEASE - EA EMPLOYEE11 $ (Mardatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below E. L. DISEASE -POLICY LIMIT 1 $ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) City of Fort Collins, its officers, agents and employees are included as additional insureds as required by written contract for insured's work. The insurance evidenced by this Certificate will not be cancelled or materially altered, except after ten (10) days written notice has been received by the City of Fort Collins. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Fort Collins THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Director of Purchasing & Risk Management John Stephen/Jan ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE P.O. Box 580 Ft. Collins CO 80522 AGA DAL Ralph Hamm © 1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD CERT NO.: 15043804 CLIENT CODE: 30YENTECOM (AGA DAL) Jana aurehfie Ld 12/21/2012 9:33:08 AM Page L Of L