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HomeMy WebLinkAboutSTEVE SCHMIDT TRUCKING INC - INSURANCE CERTIFICATEACORD CERTIFICATE OF LIABILITY INSURANCE REVISED D 08/20/2013Y) PRODUCER Serial # 114111 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION MACHANN INSURANCE AGENCY 11160 NO. HURON, STE. 36 ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. NORTHGLENN, CO 80234 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A: ACUITY A MUTUAL INSURANCE COMPANY STEVE SCHMIDT TRUCKING, INC. INSURER B: PINNACOL ASSURANCE P.O. BOX 740 INSURER C: INSURER D: WINDSOR, CO 80550-0704 INSURER E: COVERAGES 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 POLICES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES, AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR ADUL NSR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE MM/DD/YY POLICY EXPIRATION DATE MM/DD/YY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY CLAIMS MADE � OCCUR DAMAGE TO RENTED PREMISES Ea occurence $ 100,000 MED EXP (Anyone person) $ 5,000 A L68262 8/29/13 8/29/13 PERSONAL B ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GENT AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2,000,000 FD POLICY PRO- JECT LOC 71 AUTOMOBILE LIABILITY ANY AUTO COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 BODILY INJURY (Per person) $ A X ALL OWNED AUTOS X SCHEDULED AUTOS L68262 8/29/13 8/29/14 BODILY INJURY (Per accident) $ X HIRED AUTOS NON -OWNED AUTOS PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC $ ANY AUTO $ AUTO ONLY: AGG EXCESS/UMBRELLA LIABILITY OCCUR CLAIMS MADE EACH OCCURRENCE $ AGGREGATE $ DEDUCTIBLE $ RETENTION $ .B WORKER'S COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICERIMEMBER EXCLUDED? If yes, describe under SPECIAL PROVISIONS below 4051302 1/1/13 1/1/14 X WC STATU- OTH- TORY LIMITS I ER EL EACH ACCIDENT $ 500,000 EL DISEASE - EA EMPLOYEE $ 500,000 EL DISEASE - POLICY LIMIT Is 500,000 OTHER LIMIT: $10,000 A MOTOR TRUCK CARGO L68262 ..................................... 8/29/13 ..................... 8/29/14 ..................... DEDUCTIBLE: $500 DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS CERTIFICATE HOLDER IS AN ADDITIONAL INSUREDS PER ATTACHED CG 2010 (7-04) ON THE GENERAL LIABILITY. ADDITIONAL INSURED STATUS INCLUDES AUTOMOBILE LIABILITY. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION CITY OF FORT COLLINS PURCHASING DEPT. DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL P.O. BOX 580 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR FT. COLLINS, CO 80522-0580 FAX: 970-221-6707 REPRESENTATIVES. AUTHORIZED REPRESENTATIVE AGUKU 25 (ZU1J1/U6) © ACORD CORPORATION 1988