Loading...
HomeMy WebLinkAbout458840 C & S SPECIALTY SYSTEMS INC - INSURANCE CERTIFICATE (7)A�� �® CERTIFICATE OF LIABILITY INSURANCE z/7/2013YYY, 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 rightstothe certificate holder in lieu of such endorsement(s). PRODUCER Colorado HW-Insurance Agency, Inc. PO Box 3849;"- I '- -- - - - Evergreen CO 80437 ONT ACT CONTACT Johna Moors - - PHONEExt, (303)674-5501 FRILIN 0, 13031674-3571 EAIL .johna.moors@bankofthewest.com AbMADRLES,.Johna.moors@bankofthewest.com INSURERS AFFORDING COVERAGE - NAICN INSURER A:SCottadale Ins Co INSURED hgQIHG C & S Specialty Systems Inc 5609 W 6th Ave., Unit B Lakewood CO 80214 INSURERB:State Auto Insurance Companies INSURERC:Pinnacol Assurance 41190 INSURER D: INSURER E INSURER F: COVERAGES CERTIFICATE NUMBER:13-14 ALL 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 R TYPE OF INSURANCE DL SUER POLICY NUMBER MOL DDYEFF POLICY EXP (MMIDDNYYYI LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY NTE PREMISES (Ed occurrence) 8 100,000 MED EXP (My one person) $ 51000 A CLAIMS -MADE OX OCCUR CPS1730284 /8/2013 /8/2014 PERSONAL$ ADV INJURY $ 11 000,000 - GENERAL AGGREGATE $ _ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG. $. Include S POLICY X PRO- LOC- AUTOMOBILE LIABILITY _ COMBINED SINGLE LIMIT' - (Ea accident- +' 1,000,0010 BODILY INJURY (Per person) $ B X ANY AUTO - - ALL OWNED SCHEDULED AUTOS AUTOS NON -OWNED HIRED AUTOS AUTOS BAP222069304 /1/2012 - /1/2013 BODILY INJURY (Per accident)$ PROPERTY n DAMAGE $ Uninsured motorist 8151M1 limit $ 1 GGD 000 W X UMBRELLA LAB X OCCUR EACH OCCURRENCE S 4,000,000 AGGREGATE $ 4,000,000 A EXCESS LIAR CLAIMS -MADE DED I I RETENTION$ 1 $. PCBS0028190 /8/2013 /8/2014 C WORKERS COMPENSATION X WC STATU- OTH. AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED) (Mandalorir in NH) N/A 143782 /1/2013 /1/2014 E.L. DISEASE - EA EMPLOYEE $ 1 000,000 E.L. DISEASE -POLICY LIMIT S 1,000,000 If yes, describe under DE SCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more apace Is required) City of Fort Collins P.O. Box 580 Fort Collins, CO 80522 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 ACORD 25 (2010/05) Johna Moors/EVEJM .�Pp�^—� Y © 1988.2010 ACORD CORPORATION. All rights reserved. INS025 (201005)D1 The ACORD name and logo are registered marks of ACORD