HomeMy WebLinkAboutTHE BAUEN CORPORATION - INSURANCE CERTIFICATEACORD, CERTIFICATE OF LIABILITY INSURANCE 5/12ot4
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°"9/23/2 13
9/23/2013
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(les) must he 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 endoreement(s).
PRODUCER Lockton Companies, LLC Denver
8110 E Union Avenue
Suite 700
Denver CO 80237
(303)414.6000
CONTACT
INC,AM FAX
No Ex AC No
E-MAIL
ADDRESS
AFFORDING
INSURERA: Vallev Forge Insurance Coman
2050
INSURED The Bauen Corporation
1034102 801 E. 52nd Ave.
Denver, CO 80216
INSURER B : Continental Casualty Companv
20443
INSURERC: Pinnacol Assurance Com anv
41190
I The Continental Insurance Com am
352 9
INSURER F
COVERAGES RAI TC003 CERTIFICATE NUMBER' 1991907 REVISION NUMBER: XXXXXXX
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.
IN R
TYPE OF INSURANCE
AD L
R
POLICY NUMBER
P L%C FF
PO I YEXP
INIM
LIMITS
A
GENERAL LIABILITY
X COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE 7 OCCUR
N
N
4021109791
5/1/2013
5/I/2014
EACH
OCCURRENCE
s 1000000
PRE
ET REoccuNTED
100000
MED EXP (Any one Persom
S 5,000
PERSONAL a ADV INJURY
If 1,000,000
GENERAL AGGREGATE
$ 2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
X PRO,
PRODUCTS - COMPIOP AGG
$ 2000000
$
D
AUTOMOBILE
LIABILITY
ANY AUTO
AL SUHEOULED
HIRED AUTOS X AUT�INED
N
N
4021110598
5/1/2013
5/1/2014
COMBINED SINGLE LIMIT
$ 1 000 000
X
BODILY INJURY (Per person)
$ yy)OCYM
BODILY INJURY (Per accident
$ XXXXXXX
X
PerraccidenDAMAGE
$ XXXXXXX
$XXXXXXX
B
}(
UMBRELLA LIAB
EXCESS LIAR
X
OCCUR
CLAIMS -MADE
N
N
4021109807
5/1R013
5/1/2014
EACH OCCURRENCE
$ 5,000,000
AGGREGATE
$ 5,000,000
DED I I RETENTION$
s XXXXXXX
C
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY YIN
ANY PROPRIETORRPARTNEIVE)(EOLMVE
OFF(CERIMEMBER E CLUDEW N
IManOWory In NH)
DESCRIPTION OF OPERLTIONe Eebv
NIA
N
2127630
ID/IY2013
10/1/2014
STATU- OTH-
X T Y MIT
E.L. EACH ACCIDENTS
1,000,000
E.L. DISEASE. EA EMPLOYEE
s 1000000
E.LDISEASE POLICY LIMIT
1,000,000
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I(Anach ACORD 101, Additional Remarks Schedule, if more space is required)
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THL EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
1991907
City of Fort Collins
P.O. Box 580
Fort Collins CO 80522
Amon n i9nlnmRl n 1OR12010 ACORD CORPORATION. All rights reserved
The ArnOn name o 4 Inn am m..:NnrnH maLo of ACr1Rr1