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HomeMy WebLinkAbout119080 ROCKY MOUNTAIN BATTERY SERVICE OF FC - INSURANCE CERTIFICATEi
,4c R CERTIFICATE OF LIABILITY INSURANCE D"�`M'"'°°"'"Y'
10/04/2012
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
BELOWi 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(km) must be endorsed. If SUBROGATION IS WAIVED, subject to
the ternie and conditions of the policy, certain poilcles may require an endorsement. A staternsnt on this certificate does not confer rights to the
certificate holder In lieu of such endorsement(s).
PRODUCER
Stansfield Insurance Agency
6126 S College Ave, Suite 13
Fort Collins, CO 80525
nh.97'0-204.0020 fX-970-204-0305
INSURED
Rocky Mountain Battery Service Of Fort Collins Inc.
1476 N College Avenue
Fort Collins Co 80524
ocinn,nu u,runco.
COVERAGES
THIS
INDICATED.
CERTIFICATE
EXCLUSIONS
t:hxIII-IVAlC
IS 7O CERTIFY THAT THE POLICIES
NOTWITHSTANUING ANY REQUIREMENT,
MAY BE ISSUED OR MAY PERTAIN,
AND CONDITIONS OF SUCH
TYPHOFINSURANCE
OF INSURANCE
POLICIES.
ryt,mOGr[:
LISTED BELOW HAVE BEEN
TERM OR CONDITION OF ANY
THE INSURANCE AFFORDED BY
LIMITS SHOWN MAY HAVE BEEN REDUCED
POLICYNUMBER
ISSUED TO
CONTRACT
THE POLICIES
BY
POLICYEFF
M
THE INSURED
OR OTHER DOCUMENT
DESCRIBED
PAID CLAIMS.
POLICYEXP
_.._._._ _____.___
NAMED ABOVE FOR THE POLICY PERIOD
WITH RESPECT TO WHICH THIS
HEREIN IS SUBJECT TO ALL THE TERMS,
LIMITS
ILSR
B
A
GENE11ALL1ABILITY
X LIOMMERCIALGENERALLIABILITY
CLAIMS44ADE A I OCCUR
X -Comp Ops
LBA11135800
603271522
10/031201210/0312013
5/08/x01005/09/2011
6109/11
5/09/12
06/09/12
D5/09113
EACH OCCURRENCE
a1 ODOD00
EMISES Eao_QWMce
S1 DDDDOD
MED EXP (Arty one Person)—.
S 6,000
PERSONAL8ADVINJURY
$1 00D 000
GENERALAGGREGATE
s2,000,000
X
_Prod
Broad FormPA
PRODUCTS-COMPlOPAGG
;2000DOO
GEN'I!AGGREGATELIMrrAPPUESPER=
rx-1 pOLIGY LOC
AU70MDOLELIABILITY
X ANY AUTO
X ALLOWNPDAUTOS
$CHEOULED ros
Fire Legal
(COMacideentSiNGLELIMIT
S 10D 000
$1,000,000
SODILYINJURY (Per person)
$
BODILYINJURY(Peraccid-t)
S
PROPERTY DAMAGE
(Per accident)
$
HIRED AUTOS
$
NON-0WNED AUTOS
$
UMBRELLA LU16 OCCUR
EXCESS LIAR CLAIMS -MADE
EACH OCCURRENCE
S
AGGREGATE
$
$
N ! A
DEDUCTIBLE
RETENTION
WORKERS COMPENSATION
AND OMPLOYERS' LIABILITY YIN
ANY PROPRIEfORIPARTNER/EXECUTIVEQ
(OMICES BER EXCLUDED?
attyyeess,,
DESEdescr under RATIONS below
RiprnpN OF
I WCSTATU- OTH•
LIMITS
S
E.L.EACH ACCIDENT
S
E.L. DISEASE - EA EMPLOYE
S
E.LOISEASE-POLICY LIMIT
S
I
DESCRIPTION OP OPERATIONS i LOCATIONS / VEI ICLES (Attach ACORD 101, Additional Remarks Schadale, if more space is required)
Battery gealerlRecycling Services
New Belgium Brewing Co. is listed as additional insured. Waiver of Subrogation has been ordered from Farmers and Landmark American Insurance Company.
City of Fort Collins Is listed as Additional Insured.
City of Fort Collins
PO Boz 580
Fort CJIIIns CO 80622
phone#970.221 -D775
fax#970-221.6707
Attn: E Bonnette
f
ACORD`25 (2009109)
SHOULD ANY OP THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREDF, NOTICE VOLL BE DELIVERED IN
ACCORDANCE VATH THE POLICY PROVISIONS,
AUTHORIZED REPRESENTATIVE
©1988.2009 ACORD CORPORATION. All fights reserved.
The ACORD name and logo are registered marks of ACORD
NO = 4f ARM E !�
FINANCIAL SERVICES
STANSFIELD INSURANCE & FINANCIAL SERVICES
C. David ShartsfieId, LTFCF
5125 S_ College Ave- #Belp
F;: Collins, CA i�25 s
office: 97o-204-ooao
Fax 970-204-0305 A P
Emad: dswnsfWd@rwmarsagentcom
FACSYMME TRANSMrrTAL SHEET
,Ed (env
Cow-mNY:
I�.j7RGENT ©FORREVIEW ❑ PT_EASE COMMENT PLEASE REPLY AC nTRE RECYC'E
Tm*OIEVCO2DEN£5.
ACO,hRJi7® CERTIFICATE OF LIABILITY INSURANCE loos/20 2 n
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 ceRificata holder is an ADDITIONAL INSURED, the policy(les) must be endorsed. N 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
PRODUCER
Stanfield Insurance Agency
6126 S College Ave, Suite B
Fort Collins, CO 80625
oh470-204-0020 fx'970-204-0305
INSURED
Rocky Mountain Battery Service Of Fort Collins Inc.
1476 N College Avenue
Fort Collins Co 80524
�3TILIWa
CUVbKAUCbTHIS 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 POUCYINT POUCYEXP LIMITS
TYPEOFINSURANCE POLICY NUYeEA M
GENERALLIAmLITY LBA111356DO 10103120121010312013 EACH OCCURRENCE $1000000
B X COMMERCIAL GENERAL LIABILITY EMISES Ea ecw M E1000000
''. CLAIMS41ADF Fx—I OCCUR MED E](P (Any. Pmsan) $ 6,000
X Prod -Comp On PERSONALSADVIWURY $1.000,000
X Broad Form PD GENERALAGGREGATE s2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS-COMPIOP AGG s2000000
X POLICY PRO- Loc Fire Legal E 100.000
A
AUTOMOBILE
Lu" '
(COMA IS. �Nf'NOISINGLE LIMIT
$1,000,000
ANY AUTO
ALL OWNED AUTOS
603271522
0510912010
5109111
05/091M I I
06/09/12
j(
BODILY INJURY (Per ;—)
f
X
BODILY INXIRY (Per aoftlenU
$
SCHEDULEDAUTOS
5/08/12
05/09/13
PROPERTY DAMAGE
(Pe<acddNM)
f
HIRED AUTOS
f
NON -OWNED AUTOS
S
UMBRELLA LMB
OCCUR
EACH OCCURRENCE
E
EXCESS UAB
CLAIMS -MADE
AGGREGATE
f
f
DEDUCTIBLE
RETENTION E
WORk6b3 COMPENBAiIIXi
W>; 3TATU- DTH-
E
E.L. EACH ACCIDEM'
$
AND EMPLOYERS' LIABILITY YIN
ANY PROPRIETOWPARTNER/ ECUTIVE❑
FFI
OMantulwy EXCLUDED?
NIA
E.L. DISEASE - EA EMPLOYE
E
DFSGRIaP OWN RATIONS below
EL DISEASE-POUCY LIMIT E
DESCPoPTN]N OF OPERATIDNS/LOCATNNISI VEHICLES (Aswa ACORD teL AtleiaonalRe,paHa Scl,sduN,'rf more spa�ep regehed)
Battery LjealeaRecycling Services
New Belgium Brewing Co. is listed as additional insured. Waiver of Subrogation has been ordered from Farltss and Landmark American Insurance Company.
City of Fort Collins Is listed as Additional insured.
City Of Fort Collins SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
PO Box 580 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
Fort Collins CO 80622 ACCORDANCE WITH THE POLICY PROVISIONS,
phone#970-221.8775
fax#970-221.6707 AUTHORIZED
REPRESENTATIVE
Attn: Ed Bonnette
f/®, 1988.2009 ACORD CORPORATION. All rights reserved.
ACORD 25 (2009109) The ACORD name and logo are registered marks of ACORD