HomeMy WebLinkAboutCRW INC - INSURANCE CERTIFICATE (3)A�� "® CERTIFICATE OF LIABILITY INSURANCE
5�1/2013YTY)
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 endomement(s).
PRODUCER
Cc West Insurance Group
P.O. BOX 910
Castle Rock CO 80104
CONTACT COWest Corporate
NAME: rP
PHDNE (303) 688-9597 FAX o. (303)688-8856
E-MAIL
-ADDRESS'info@cowest.com
INSURERS AFFORDING COVERAGE
NAICN
INSURER A Landmark American
INSURED
CRW, Inc
PO BOX 631067
Highlands Ranch CO 80163
INSURERB:Oh.io Security
24082
INSURERCRSUI Indemnity
INSURER D:
INSURER E :
INSURER F:
COVERAGES CERTIFICATE NUMBERMaster 13/14 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
TR
OF INSURANCE
ADDLTYPE
1UR
yn
POLICY NUMBER
EFF
MWDDIYYYY
MLICY
W LICY EXP
DDYYYY
LIMITS
GENERAL LIABILITY
EACH OCCURRENCE
$ 1,000,000
A
X COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE OCCUR
LEU1136787
/26/2013
/26/2014
PREMISES aoccurrence)
$ 50,000
MED EXP(Any one person)
$ EXCLUDED
PERSONAL S ADV INJURY
$ 1,000,000
GENERAL AGGREGATE
$ 2,000,000
GENE. AGGREGATE LIMIT APPLIES PER
PRODUCTS - COMP/OP AGG
$ 2,000,000
X POLICY PRO -
FLOC
I
$
AUTOMOBILE
LIABILITY
COMBINED SINGLE LIMIT
Ea accident
1,000,000
X
BODILY INJURY (Per person)
$
B
ANY AUTO
ALL OWNED SCHEDULED
AUTOS AUTOS
BAS55508292
/26/2013
/26/2014
BODILY INJURY (Per accident)
$
PROPERTY DAMAGE
Per accident
$
HIRED AUTOS NON-OA0I
AUTOS
Medical menis
S $ 000
X
UMBRELLA LIAR
X
OCCUR
EACH OCCURRENCE
$ 1,000,000
AGGREGATE
$
C
EXCESS LEAD
CLAIMS -MADE
LED I X I RETENTIONS 10, 00
1
Is
32625
/26/2013
/26/2014
WORKERS COMPENSATION
WC STATD- I OTH-
FIR
AND EMPLOYERS' LIABILITY Y I NUM
ANY PROPRIETORIPARTNEWEXECUTIVE❑
E.L. EACH ACCIDENT
S
OFFICERIMEMBER EXCLUDED?
NIA
E.L. DISEASE - EA EMPLOYE
$
(Mandatory in NH)
It yes descnbe under
DESCRIPTION OF OPERATIONS below
E.L. DISEASE -POLICY LIMIT
$
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule. It more space Is mqulmd)
City of Fort Collins, its officers, agents and employees are named as additional insured as pertains to
General Liability.
City of Fort Collins
City Director of Purchasing and Risk Mans
215 N Mason Street
2nd Floor/PO 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
Caskey/SLB
ACORD 25 (2010/05)
INSn26 oninnsl n1 Tho Arnan uomo and Innn =ro rcnicfcrud martre ^f Arnan
All rights reserved.