HomeMy WebLinkAbout375464 DAVINCI SIGN SYSTEMS INC - INSURANCE CERTIFICATE (4)UP IU: NK
ATE ,acoRor CERTIFICATE OF LIABILITY INSURANCE D05/28/2013 Y)
05/28/2013
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
PRODUCER
PFS Insurance Group - JT
4848 Thompson Pkwy, Ste 200
Hintzman
INSURED
4496 Bents Drive
Windsor, CO 80550
Phone:
Fax:
INSURER C :
DAVIN-1
Assurance
COVERAGE
COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
NAIC N
190
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.
INIRADDL
R TYPE OF INSURANCE I IWO II POLICY NUMBER MMIDD/YYYY) I (MM1D[[VYYYYJ LIMITS
GENERAL LIABILITY
COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE OCCUR
NIA
EACH OCCURRENCE
DAMAGE TORENTED
PREMISES (Ea occurrence l
$
$
MED EXP(Any one person)
$
PERSONAL & ADV INJURY
$
GENERALAGGREGATE
$
GEN'L AGGREGATE LIMIT APPLIES PER:
POLICY F-1 PRO n LOC
PRODUCTS - COMP/OP AGG
$
I $
AUTOMOBILE
LIABILITY
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NONOWNEDAUTOS
N/A
COMBINED SINGLE LIMIT
(Ea accidenq
$
BODILY INJURY (Per person)
$
BODILY INJURY (Per accident)
$
PROPERTY DAMAGE
(Per accident)
$
I -I
$
$
UMBRELLA LIAB
EXCESS LIAB
OCCUR
N/A
RRENCE
AGGREGATE
$
DEDUCTIBLE
RETENTION $
$
Is
A
A
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY
ANY PROPRIETOR/PARTNER/EXECUTIVE YIN
OFFICER/MEMBEREXCLUOG9 �N
(Mandatory in NH)
If yes, describe under
DESCRIPTION OF OPERATIONS below
NIA
4081336
07/01/2013
07/01/2014
WC STATU- OTH-
X T RY LIMITS ER
EL. EACH ACCIDENT
$ 1,OOQ000
IEL . DISEASE - EA EMPLOYEE$
1,000,000
E.L. DISEASE -POLICY LIMIT 1
$ 1,000,000
N/A
DESCRIPTION OF OPERATIONS / LOCATIONS/ VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required)
Project: 7062 Council Tree Exterior Signage
CITYFTC
City of Ft. Collins
Financial Services/Purchasing
Division
P.O. Box 580
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
4
9)1988-2009 ACORD CORPORATION. All rights reserved.
ACORD 25 (2009/09) The ACORD name and logo are registered marks of ACORD