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Home My WebLink About119080 ROCKY MOUNTAIN BATTERY SERVICE - INSURANCE CERTIFICATE (3)10/21/2013 12:55 9702040305 STANSFIELD INSURANCE PAGE 01 ACAORo® CERTIFICATE OF LIABILITY INSURANCE 10121120113�m 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 terns 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 Stansfield Insurance Agency 5125 S College Ave, Suite B Fort Collins, CO 80525 CONTACT NAME A°H�c°N ; Ekt:970-204-0020 ac NO: 970 204-0305 EMAIL ADDRESS: ODUCER C STOMER ID#. INSURERS AFFORDING COVERAGE NAIC # ph-070-204-0020 fx-970-204-0305 INSURED Rocky Mountain Battery Service INSURER A: Farmers Insurance INSURERS: COVin ton S laity Insurance Com an INSURERC: 1475 N College Avenue INSURER D: Fort Collins Co 80524 INSl/RER E INSURER F COVERAGES THIS INDICATED. CERTIFICATE EXCLUSIONS INSR LTR B A G]=K IS TO CERTIFY THAT THE POLICIES NOTWITHSTANDING ANY REQUIREMENT, MAY BE ISSUED OR MAY PERTAIN, AND CONDITIONS OF SUCH TYPE OF INSURANCE GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLA/IM�S-MADE � OCCUR X Prod -COMP IlrlaA OF INSURANCE POLICIES. IN A l c THE UBR WVD NUIMO=c. LISTED BELOW HAVE BEEN TERM OR CONDITION OF ANY INSURANCE AFFORDED BY LIMITS SHOWN MAY HAVE BEEN REDUCED POLICY NUMBER VBA214800 00 603271522 ISSUED TO CONTRACT THE POLICIES BY PO ICYEFF MMD 10/03/2012 10/03/201310/03/2014 109111 5109/12 THE INSURED OR OTHER DOCUMENT DESCRIBED PAID CLAIMS. POLICYE%P MMID 10/03/2013 05/09/12 5/09/13 "-"-------- NAMED ABOVE FOR THE POLICY PERIOD WITH RESPECT TO WHICH THIS HEREIN IS SUBJECT TO ALL THE TERMS, LIMITS EACH OCCURRENCE $1 000 000 PREMISES occunence $1000000 MED EXP (Any one Person) $ 5,000 PERSONAL SADVINJURY $1000000 GENERALAGGREGATE s2,000,000 X Broad Form PD PRODUCTS-COMPIOPAGG s2000000 GEN-L AGGREGATE LIMIT APPLIES PER: X POLICY Pn LOC AUTOMOBILE LIABILITY X ANY AUTO X ALLOANEDAIfTOS Fire L al COMBINED SINGLE LIMIT (Ea accMem) $ 1lX) 000 $1,000,000 BODILY INJURY (Per Person) $ 6ODILYINJURY(Pe1a¢Ideld) S SCHEDULED AUTOS 5109113 5/09/14 PROPERTYDAMAGE (Per acadnd) $ HIRED AUTOS NON-0AR1ED AUTOS S UMBRELLA LU(B OCCUR OCCUR NCE S EXCESS LIAB MADE S _ DEDUCTIBLE RETENTION $ WORKERSCOMPENSATION ;AGGRMATE OTH- 8 AND EMPLOYERS LIABILITY YINANY PROPRIETORIPARTNERIIXECUTIVEEM EL. DISEASE- EA EMPLOY $ OFFICERIMEMBER EXCLUDEDY ❑ (Mandatory in NH) NIA If yyes, describe under pESCRIPTION OF OPERATIONS belwv E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Atteeh ACORD 101, Addldonal Remarks Schedule, if more space is required) Battery Dealer/Recycling Services New Belgium Brewing Co. is listed as additional insured. Waiver of Subrogation has been attached from Farmers and Covington Specialty Insurance Company. City of Fort Collins PO Box 580 Fort Collins CO 80522 phone#970-221-6775 fax#970-221.8707 Attn: Ed Bonnette 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 dR (c)1999-2009 ACORD 25 (2009109) The ACORD name and logo are registered marks of ACORD TION. All rights reserved. 10/21/2013 12:57 9702040305 STANSFIELD INSURANCE PAGE 01 ,4coR0® CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 10/21/2013 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 polky(ies) must be endorsed. If SUBROGATION IS WANED, 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 Stansfield Insurance Agency c NAME FAX PHONN EXe: 970-204-0020(Mo.No: 970-204-0305 EMA IL ADEME W. 5125 S College Ave, Suite B Fort Collins, CO 80525 PRo C STOMCFR [R IOC INSURERS AFFORDING COVERAGE NAIC # ph-970-204-0020 fx-970-204-0305 INSURED Rocky Mountain Battery Service NSURERA: Farmers Insurance iNsugegs. Covington Specialty Insurance Company INWRERC: 1475 N College Avenue INSURER D: Fort Collins Co 80524 INSURER E: INSURER F COVERAGES THIS INDICATED. CERTIFICATE EXCLUSIONS IN9R LTR B A I:ew IS TO CERTIFY THAT THE POLICIES NOTWITHSTANDING ANY REQUIREMENT, MAY BE ISSUED OR MAY PERTAIN, AND CONDITIONS OF SUCH TYPE OF INSURANCE GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE Lxl OCCUR X Prod -Comp Ops nrlt-m.o OF INSURANCE POLICIES. ADDL INSR SU lYamor=n. LISTED BELOW HAVE BEEN TERM OR CONDITION OF ANY THE INSURANCE AFFORDED BY LIMITS SHOWN MAY HAVE BEEN REDUCED POLICY NUMBER VBA21480000 ISSUED TO CONTRACT THE POUCIES BY POLICYEFF MMID 10103/201210/0312013 10/03/201310/03/2014 -------- THE INSURED OR OTHER DOCUMENT DESCRIBED PAID CLAIMS. POLICYEXP dW MMIOY NAMED ABOVE FOR THE POLICY PERIOD WITH RESPECT TO WHICH THIS HEREIN IS SUBJECT TO ALL THE TERMS, LIMITS EACH OCCURRENCE $1000000 PREMISES aoccunenre $1000000 MED FXP (Any one person) $ 5.000 PERSONAL S ADV INJURY $1 000.000 GENERAL AGGREGATE s2 000 DOO X Broad Form PD PRODUCTS- COMPIOP AGG $2000000 GEN'L AGGREGATE LIMIT APPLIES PER: X Poucv P� Loc AUTOMOBILELIABILITY Fire Legal COMBINED SINGLE LIMIT (Fa axideM) $ 100,000 $1,000,000 )( ANY AUTO X ALLOVMEDAUTOS 603271522 /09/11 5109112 05/09/12 05/09/13 NoULY INJURY (Per person) $ BODILYINJURY (Pera6itlem) S SCHEDULED AUTOS 5109113 5/09114 PROPERTYDAMAGE (Peracdderd) $ HIRED AUTOS NON -OWNED AUTOS — S UMBRELLA LU\B OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLNM&MADE DEDUCTIBLE - RETENTION S WORKQiSCOMPENSATION AND EMPLOYERS LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ OFFICERNEMBER EXCLUDEDT (Mandatory in NH) NIA VJC STAT T, OTH- T T E $ E.L. Fi(4 - I A S c E.L. DISEA L I(yee, dexribe under DESCRIPTION OF OPERATIONS bebv E.L DISEASE -POLICY LIMIT $ DESCRIPTION OF OPERATIONS/ LOCATIONS/ VEHICLES (AMich ACORD 101, Additional Remarks schedule, N more Spare Is required) Battery Dealer/Recycling Services New Belgium Brewing Co. is listed as additional insured. Waiver of Subrogation has been attached from Farmers and Covington Specialty Insurance Company. City of Fort Collins PO Box 580 Fort Collins CO 80522 phone#970-221.6775 faX#970-221.6707 Attn: Ed Bonnette SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL SE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPREj�SwEtNfT.A�T�IVJE X CORPORATION. All rights reserved. ACORD 25 (2009109) The ACORD name and logo are registered marks of ACORD