HomeMy WebLinkAboutMCDONALD FARMS ENTERPRISES INC - INSURANCE CERTIFICATEA� De CERTIFICATE OF LIABILITY INSURANCE
DATE (MM/DDNYYV)
9/12/2012
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 isan ADDITIONAL INSURED, the policy(les) 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
Keller -Lowry Insurance Inc
1777 S Harrison St H700
Denver CO 80210
AN. Bill Code CL006 Herndon
PHONE (303)756-9909 FAX (303)756-081e
'NAIL .icanhelp@kellerlowry.com
INSURERS AFFORDING COVERAGE
NAIC a
INSURER A:Techonolocry Insurance CO Inc
INSURED
McDonald Farms Enterprises, Inc
7247 E County Line Rd
Longmont CO 80504
INSUREA181andmark American Insurance CO
I INSURER C:
INSURER D:
NSURER E
INSURER F:
COVERAGES CERTIFICATE NUMBER:12/13 al be cargo umb 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.
IN
LTR
TYPE OF INSURANCE
ADDLSUBR
POLICY NUMBER
POL CY EFF
POL CY EXP
LIMITS
A
GENERAL LIABILITY
X COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE FOOCCUR
TPPI013641 00
9/15/2012
9/15/2013
EACH OCCURRENCE
$ 1,000,000
PREMISES n
$ 100,000
NED EXP (My one arson
$ 5,000
PERSONAL S ADV INJURY
$ 1,000,000
GENERAL AGGREGATE
$ 2,000,000
GENL AGGREGATE UNIT APPLIES PER:
X POLICY PRO- LOC
PRODUCTS-COMP/OP AGG
$ 2,000,000
$
A
AUTOMOBILE
LIABILITY
ANY AUTO
ALL OWNED SCHEDULED
AUTOS AUTOS
HIRED AUTOS X AUTOS
P21013641 00
/15/2012
9/15/2013
COMBINED SIN LE LIMB(Ea accident)
S 11000,00
BODILY INJURY (Par person)
$
Ix
BODILY INJURY (Per accident)
$
PPROPERTY DAMAGE
$
Medicate ants
S 5 000
B
X
UMBRELLA LIAR
EXCESS DAB
X
OCCUR
CLAIMS -MADE
HN051601
9/15/2012
/15/2013
EACH OCCURRENCE
S 4,000,000
AGGREGATE
$ 4,000,000
OED X RETENTION 10,00C
$
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY YIN
ANY PROPRIETORIPARTNER/EXECUTIVE
OFFICERIMEMBER EXCLUDED?
(Mandatory in NH)
u yas, dascnl» ones.
DESCRIPTION OF OPERATIONS ENow
NIA
WC STATU- GTH-
TORY
E. L. EACH ACCIDENT
$
E.L. DISEASE - EA EMPLOYE
$
E.L. DISEASE -POLICY LIMIT
$
A
Cargo
Special Form
rPp1013641 00
/15/2012
/15/2013
Umit $60,000
Deductible $1, 000
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101, Additional Remarks Schedule, N mom space is rpulned)
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
o
Sibelius CIC CRM/KA
ACORD 25 (2010/OS) C 1988-2010 ACORD CORPORATION. All rights
„\JVLJ tNIWJ).VI I ne AGUKU name and loco are registered marks of ACORD