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HomeMy WebLinkAbout104133 FORT COLLINS MONUMENT WORKS LLP - INSURANCE CERTIFICATEACORD CERTIFICATE OF LIABILITY INSURANCE rN DATE 18/2013 07/18/2013 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). PRODUCERCONTACT Ewing -Leavitt Insurance Agency 4025 St. Cloud Dr. NAME: Karole Peters aCG,"N E:f:970.679.7355 jac,Np):866.237.2178 ADDRESS: karole-peters@leavitt.com Suite 100 INSURERIS) AFFORDING COVERAGE NAIC M Loveland, CO 80538 INSURER A: Cincinnati Insurance Co 10677 INSURED Fort Collins Monument Works LLP INSURER B: DBA: Fort Collins Monument & Stone LLP INSURER C: 824 E. Lincoln Ave INSURER D: Ft Collins, CO 80524 INSURER E: INSURER F COVERAGES CERTIFICATE NUMBER: 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. 7N5 TYPE OF INSURANCE AD PODCYEFFTPOLIC LTR INSR VIVO POLICY NUMBER MMIDD/YVVV MM/DO/YYYY LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE a OCCUR X Blkt Addl Insured EPP0202982107/2412013 07124/2014 EACH OCCURRENCE $ 1,000,000 PREMISES Ea occurrence $ 500,000 MED EXP(Any one person) $ 10,000 PERSONAL S ADV INJURY $ 1,000,000 X Blkt Waiver of Sub GENERAL AGGREGATE $ 2,000,00 GENT AGGREGATE LIMIT APPLIES PER: X POLICY � PE� LOC PRODUCTS - COMP/OP AGG $ 2,000,00 S A AUTOMOBILE LIABILITY ANY AUTO ALL AUTOS OWNED AUTOSSCHED NON-OX HIREDAUTOS X AUTOSWNED EPP0202982 07/2412013 07/2412014 Ea accident $ 1,000,000 X BODILY INJURY (Per person) $ BODILY BODILY INJURY (Per accident) (Per accident)DAMAG $ $ A )( UMBRELLA LIAR EXCESS LIAR X OCCUR CLAIMS -MADE EPP0202982'.07I2412013 07124/2014 EACH OCCURRENCE $ 1,000,00 AGGREGATE $ 1,000,000 DED X RETENTION$ 10,00q $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETORIPARTNERIEXECUTIVE❑ OFFICERIMEMBER EXCLUDED? (Mandatory In NN) If yes. describe under DESCRIPTION OF OPERATIONS below NIA A U- H- TORV LIMIT$ ER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYE $ EL. DISEASE -POLICY LIMIT $ F —_ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remadfs Schedule, if more space Is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of Fort Collins Attn: Alyce Carpenter AUTHORIZED REPRESENTATIVE .l P. 0. Box 580 Fort Collins, CO BOS22 Karole Peters/KAPETE © 1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD