HomeMy WebLinkAbout505343 AHEAD START INC - INSURANCE CERTIFICATE®
A4090 CERTIFICATE OF LIABILITY INSURANCE
DATE(MMIDDYVVV)
6/3/2013
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 endorsement(s).
PRODUCER
Weedin Agency, Inc:
PO Box L -- -"
Berthoud,CO 80513
CONTACT
NAME'
HONEOI.(970) 532-3131 —3100
ac.Nn'.(970) 532
- _
ADDRESS'
INSURERIB) AFFORDING COVERAGE
NAICi
INSURERA.OWNERS INSURANCE CO
b
INSURED AHEAD START; INC
INSURER B:
INSURER C:
DBA AMY'S GREEN DRY CLEANING
INSURER D:
540 & 550 N JEFFERSON AVE
INSURER E:
LOVELAND, CO 80537
INSURER F'
COVERAGES CERTIFICATE NUMBER: 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.
ILTR
TYPE OF INSURANCE
INGR
YND
POLICY NUMBER
MWDDIY1'YY
MWDDI'M/VI
LIMITS
GENERAL LIABILITY
_
EACH OCCURRENCE
$ 2 D00 ODO
PREMISESEa occurzence -
$- 300,000
X COMMERCIAL GENERAL LIABILITY
-.
_
CLAIMS-MADEFRI OCCUR
MED EXP(Any one person) .
$ 10 000-
A
Y
74456848
11/29/1211/29/13
PERSONAL B ADV INJURY
$ 2,000,000-
GENERAL AGGREGATE
$ 3,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
PRODUCTS - CONI AGG
$ 3,000,000
X POLICY PRO- El
ECT OC
$
AUTOMOBILE
LIABILITY
Ea accident)
$ 1,000,000
X
BODILY INJURY (Per person)
$
A
ANYAUTO
ALL OWNED SCHEDULED
AUTOS AUTOS
4745684800
11/28/12
11/28/13
BODILY INJURY (Per accident)
$
NON -OWNED
HIRED AUTOS AUTOS
Per accident)
$
UMBRELLA LIAB
OCCUR
EACH OCCURRENCE
$
AGGREGATE
$
EXCESS LIAR
CLAIMS -MADE
DED I I RETENTION$
$
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY YIN
CSTATIJ- DTH-
TWORV LIMITS ER
E.L. EACH ACCIDENT
$
ANY PROPRIETORIPARTNER/E%ECUTIVE
OFFICERIMEMBER EXCLUDED?
NIA
E.L. DISEASE - EA EMPLOYE
$
IMendl a III
f yes, describe under
DESCRIPTION OF OPERATIONS below
E.L. DISEASE -POLICY LIMIT 1
$
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space's required)
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 80522-0580 ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED
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