HomeMy WebLinkAbout159569 PS INSTALLATIONS INC - INSURANCE CERTIFICATEDATE(Mw0D1YyYY)
AC•OR" CERTIFICATE OF LIABILITY( INSURANCE 9/25/2012
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(IDS) 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 Ilea of such endorsement(s).
PDr.r Mo NAME'
CO -PRO GROUP INC
5601 S BROADWAY #350
LITTLETON, CO 80121
PHA (303) 730-3715 1'XNo1;(303) 730-1024
INBURERIS) AFFORDING COVERAGE INNI'=M
INSURER A' COLORADO CASUALTY
INSURED pS INSTALLATIONS, INC. AND INSURER 8 :
SHELF IMAGE INC INSURER 0;
3857 STEELE ST UNIT C INSURER 0:
DENVER, CO 80205 INSURER E
303-297-2030 INSURER F :
COVERAGES CERTIFICATE NUMBER;
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED
INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOC
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES, LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, EW
I R TYPE OF INSURANCE a POLICY NUMBER IMF NYYY MWDDIYYYY
IN9R
GENERAL 41AEIILITY
COMMERCIAL GENERAL LIABILITY
F�' CLAIMS -MADE -- I OCCUR
A i �CBP8866177 08/17/12 00/17/13
GEN'L AGGREGATE LIMIT APPLIES PER'
POLICY191PRO LOC
JECT
AUTOMOBILE LIABILITY
X ANYAUTO BA8867677 08/17/12 08/17/23
A X ALL OWNED SCHEDULED
AUTO AUTOS
NON -OWNED
X HIRED AUTOS X AUTOS
g SPECIFI19D
UMBRELLA LIAB X OCCUR 08/17/12 08/17/13
A EXCESS LIAB CLAIMS -MADE CV$a69177
DED I X I RETENTION $ 10 000
WORKERS COMPENSATION
AND EMPLOYERS, LIABILITY YIN
ANY PROPRIETORIPARTNEAA1XICUTIVE WAOFFIGERIM MBER EXClUOE07
(Wndatary In NH)
If qas, describe under
n$ArRIPTInN eIF OPERATIONS below _.
A CARGO COVERAGE ICIBP8866177 08/17/12 08/17/13
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Atlaeh ACORD 101, Additional Remarks Schedule, If more apace Is required)
THE CITY OF FT COLLINS, IT'S OFFICERS, AGENTS AND EMPLOYEES I
INSURED
R1=viatnm KnIMRFR-
NAMED ABOVE FOR THE POLICY PERIOD
UMENT WITH RESPECT TO WHICH THIS
HEREIN IS SUBJECT TO ALL THE TERMS,
LIMITS
EACH OCCURRENCE S 1 000,000
PREMISES E0 occurrence
$ 100,000
MED EXP Any one porson)
$ 15,000
PERSONAL & ADV INJURY
$ 1 , 0 00 , 00 0
GENERAL AGGREGATE
s 2,000,000
PRODUCTS - GOMP/OP AGG
$ 2,000,000
S
Ee 3INGLE LIMIT
. dent
$ 1, 000 000
BODILY INJURY (Per parson)
$
BODILY INJURY (Peraaddent)
$
PROPER GE'
Per accident
$
S
EACH OCCURRENCE
$
AGGREGATE
$ 5,000,000
S
$TATU- OTH-
T IMITS ER
E.L. EACH ACCIDENT
$
E,L, DISEASE - EA EMPLOYE
$
E.L. DISEASE - POLICY LIMIT I $
$500,000 PER LOAD
RE NAMED AS ADDITIONAL
TE HOLDER CANCELLATION
CITY OF FT COLLINS SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
215 NORTH MASON THE: EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
FT COLLINS, CO 80524 ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED 116PRESPVTATIVE
0 1988-2010 ACORD CORPORATION. All rights reserved.
ACORD25(2010105) The ACORD name and logo are regisst�te--r��eddyymarks of ACORD
)��v 0( —
DATE(MMIOD/VVYY)
,d►corro® CERTIFICATE OF LIABILITY INSURANCE
8/22/2012
AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
THIS CERTIFICATE IS ISSUED
EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,
A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
ADDITIONAL INSURED, the policy(les) must be endorsed. If SUBROGATION IS WAIVED, subject to
IMPORTANT: If the certificate holder is an
may require an endorsement A statement on this certificate does not confer rights to the
the terms and conditions of the policy, certain policies
certlfcate holder In lieu of such endorsement(s).
PP'-"--- NAME'.
PHONE (303) 730-3715 ac.ND:(303) 730-1024
aC No EM.
- L
CO -PRO GROUP INC ADDRESS:
5601 S BROADWAY #350 f_ INSURERmf AFFORDING COVERAGE NAI
/
LITTLETON, CO 80121 J� ( INSURER A : COLORADO CASUALTY
INSURED PS INSTALLATIONS , INC • AND INSURER B
SHELF IMAGE INC INSURER C
3857 STEELE ST UNIT C NSURER O.
DENVER, CO 80205 INSURER E .
SU303-297-2030 RER
NI_IMBER: REVISION NUMBER:
COVERAGESCERTIFICATE
OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
THIS
THIS IS TO CERTIFY THAT THE POLICIES
INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH
DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES
LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.
LIMITS
INSR TYPE OF INSURANCE IN wVD POLICY NUMBER MMIDD/YYYY MMIDD/YYYY
LTR EACH OCCURRENCE
GENERAL LIABILITY
f 1,0 O00
PREMISES Ea oxumence
X COMMERCIAL GENERAL LIABILITY
MED EXP (Any one person) f 10 OOO
CLAIMS -MADE � OCCUR
CBP8866177 08/17/12 08/17/13 PERSONA LSADVINJURV f 1,000,000
A GENERAL AGGREGATE f 2,000,000
PRODUCTS - COMPIOP AGG s 2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER: f
POLICY X PEA LOC 1,000,000
f
AUTOMOBILE LABILITY INJ
LY INJURY (Per person) f
BODILY
X ANYAUTO $A8867677 08/17/12 08/17/13 BODILY INJURY (Per accident) f
ALL OW
s AUTOS f
A NED SCHEDULED X AUTO
NON-OWNED Per adent
X HIRED AUTOS X AUTOS f
X SPECIFIED
UMBRELLA LIAR
X
OCCUR
CU8869177
09/17/12
08/17/13
EACH OCCURRENCE
$
AGGREGATE
f 5,000,000
A
EXCESS LLAB
CLAIMS -MADE
$
DED X RETENTIONS lO OOO
WC STATU- TM -
WORKERS COMPENSATION
TO RV LIMITS ER
0.00
AND EMPLOYERS' LIABILITY YIN
E.L. EACH ACCIDENT
f
ANY PROPRIETORMARTNER/F.%ECU IVE Ci
OFFICERMEMRER FXCLUDEDi
NIA
E L. DISEASE - EA EMPLOYE
f
E.L. DISEASE -POLICY LIMIT E
INsnv:otl m ""'
It yes. describe Dyer
DESCRIPTION OF OPERATIONS below
CBP8866177
08/17/1208/17/13
$500,000 PER LOAD
A
CARGO COVERAGE
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Accifional Remarks Schedule, if more space is required)
EMPLOYEES ARE NAMED AS ADDITIONAL
THE CITY OF FT COLLINS, IT'S OFFICERS, AGENTS AND
INSURED
CITY OF FT COLLINS
215 NORTH MASON
FT COLLINS, CO 80524
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
GJ. AAC ,
M 1988-2010 ACORD CORPORATION. All rights reserved.
ACORD25(2010/05) The ACORD name and logo are registered marks of ACORD