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480231 SECOND WAVE AUTOMOTIVE CARE LLC - INSURANCE CERTIFICATE (2)
Client#: 52969 SECWA I �- ACORD. CERTIFICATE OF LIABILITY INSURANCE DATE(FAWODI"") 10/0112013 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 NA T ACT Suzannah Preisendorf Flood & Peterson Ins., Inc. PHONE 970-506-3261 Arc rla Etl : A e No): 970-506.6820 P. O. Box 578 ADDRESS: SProisendorf@FloodPeterson.com Greeley, CO 80632 970 356-0123 INSURER 9 AFFORDING COVERAGE xAIC INSURER A: Continental Westem Group INSURED Second Wave Automotive Care, LLC +g"o 23I INSURER B : Endless Summer Properties, LLC INSURER C: 1921 S Alma School Road, Suite 110 INSURER D: Mesa, AZ 85210 INSURER E INSURER F COVERAGES 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 CONTRACTOR 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. INSR LTRffim TYPE OF INSURANOE ADOL SUER POLICY NUMBER MMIDOY EFF POLICY LIMITS A GENERALL111BIU7ry X COMMERCIALGENERALUABILITY CLAIMS -MADE �X OCCUR X PD Ded:500 G030"137 0/01/2013 10/01/2014 EACH OCCURRENCE S1000000 RMl%EETRREEgEma $100000 MED UP ( Sete $ 5 000 PERSONAL &ADV INJURY $1006000 GENERAL AGGREGATE S$000,000 GENT AGGREGATE UMIT APPLIES PER: POLICY PRO. LOC PRODUCTS-COMP/OP AGO _ $ZOOO,000JECT S A AUTO1gdLELUIBILRY ANY AUTO ALL OWNED SCHEDULED HIRED AUTOS AlJT03 X NON-0WNED AUTOS G030"137 1010112013 10101/2014 CEO. BINEDtSl SINGLE 1,0,000 Is 00 BODILY INJURY(Per person) $ BODILY INJURY (Per accchat) S X PROPERTY DAMAGE Per acueenl S S A X UMBRELLALNB EXCESS LIAR X OCCUR CLAIMS AGE G030"137 0101/2013 1010112014 EACH OCCURRENCE $1000000 AGGREGATE $ $ _ DED RETENTIONS WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANYPROPRIETOWPARTNERIEXECUTIVEY/N OFFICERIMEMBER EXCLUDED? ❑ (Mandatory In NH) If yea, deacnbe under DESCRIPTION OF OPERATIONS theme NIA TATU- OTH- TORS' TTS - f E.L EACH ACCIDENT E.L DISEASE -EA EMPLOYEE $ E.L DISEASE -POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remams Schedule, If man apace Is required) Certificate holder is included as Additional Insured as required by written contract with respects to liability arising out of work performed by the named insured. City of Fort Collins PO Box 580 Fort Collins, CO 80522 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 W-� 0 cam- ACORD 25 (2010/05) 1 of 1 #S832671/M832670 ©1988.2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD SMP