HomeMy WebLinkAbout474788 ALL STRIPES & MAINTENANCE LLC - INSURANCE CERTIFICATEALLSTRI-01 MTUSINSKI
ACORO CERTIFICATE OF LIABILITY INSURANCE DATED/YYYY)
2/10/210/2014
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
TrueNorth
PO Box 847
Longmont, CO 80502
Michelle Tusinski
n: (303) 776-5122
mtusinski0truenl
e
INSURER A: Colorado Casualty Insurance Co 18333
INSURED INSURER B :Owners Insurance Company 32700
All Stripes & Maintenance, LLC 7� g INSURERC:
P O Box 1399 INSURER D :
Fort Collins, CO 80522 INSURER E :
INSURER F :
rr]VFRAr:FS 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 NSR
TYPE OF INSURANCE
ADWL*UUK
POLICY NUMBER
POLICY
MM/DDfYEYYY
MM//DD/YYYY
LIMITS
A
X
COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE Al OCCUR
BKS55859658
02/28/2014
02/28/2015',
EACH OCCURRENCE
$ 1,000,00
M RENTED
PD EEMMIS RES Ea occurrence
$ 300,00
MED EXP (Any one person)
$ 15,00
PERSONAL 8 ADV INJURY
$ 1,000,00
GEML AGGREGATE LIMIT APPLIES PER:
X POLICY LX JET LOC
OTHER.
GENERAL AGGREGATE
$ 2,000.00
PRODUCTS - COMP/OPAGG
$ 2,000,00
$
B
AUTOMOBILE LIABILITY
X ANY AUTO
ALL OS NED SCHEDULED
AUTOS
NON -OWNED
HIRED AUTOS HAUTOS
4825658700
0110812014
011M2016
COMBINED SINGLE LIMIT
Ea accident
$ 1,000,00
BODILY INJURY (Per person)
$
BODILY INJURY (Per accident))
$
PROPERTY DAMAGE
Per accident
$
UMBRELLA LIAB
EXCESS LIAB
OCCUR
CLAIMS -MADE
EACH OCCURRENCE
$
AGGREGATE
$
DED RETENTIONS
$
WORKERS COMPENSATIONIP
AND EMPLOYERS' LIABILITY
ANY PROPRIETOR/PARTNER/EXECUTIVE Y/❑N
:OFFICER/MEMBER EXCLUDED?
j (Mandatory in NH)
If yes, describe under
DESCRIPTION OF OPERATIONS below
NIA
STER
ATUTE ER
E_L. EACH ACCIDENT
$
$
E.L. DISEASE - EA EMPLOYEE
E.L. DISEASE -POLICY LIMIT
$
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
Certificate Holder is Additional Insured under the General Liability per written contract.
I
I
City of Fort Collins
Purchasing Division
P O Box 58
Fort Collins, CO 80522
VANIZLLA 1IVIY
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
R
V 1Vt5tf-LU14 AVVKV UUKYUKA I IVN. All nynuw reberveu.
ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD