HomeMy WebLinkAbout480231 SECOND WAVE AUTOMOTIVE CARE LLC - INSURANCE CERTIFICATE (3)'�l� h® CERTIFICATE OF LIABILITY INSURANCE
10/10/2o�l
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
CO West Insurance Group
PO BOX 910
Castle Rock CO 80104
CONTACT COWeSt
NAME: rP CO Orate
PNOE -9597 AX
.() No,. (303) 688-8858
EMAIL .info@coxest. com
INSURERS AFFORDING COVERAGE
NAICB
INSURERA:C'hlo Security
4082
INSURED
Second Wave Automotive Care Llc S Endless
1921 S Alma School Rd Ste 110 400�2
0 J
Mesa AZ 85210
INSURERB:COlorado Casualty
4074
INSURER C:
INSURER D:
INSURER E:
INSURERF:
COVERAGES CERTIFICATENUMBERMaster 13/14 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.
INSm
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFF
MMIDDIY
POLICY EXP
MIDDIYYYY
LIMITS
A
GENERAL LIABILITY
X COMMERCIAL GENERAL LIABILITY
7 CLAIMS DE �x— OCCUR
BKS555351BO
/28/2013
O/01/2013
EACH OCCURRENCE
$ 1,000,000
PREMISES acwnenoe
$ 300,000
MED EXP we person)
$ 15,000
PERSONAL B ADV INJURY
$ 1,000,000
GENERAL AGGREGATE
$ 2,000,000
GEN'L AGGREGATE
X POLICY
LIMIT APPLIES PER
PIFCTRO LOC
PRODUCTS � COMPIOP AGO
$ 2,000,000
$
A
AUTOMOBILE LIABILITY
ANY AUTO
ALL OWNED SCHEDULED
AUTOS AUTOS
X X NON -OWNED
HIRED AUTOS AUTOS
S55535180
/28/2013
0/01/2013
( MBIEs cci n IN LE LIMIT
1,000,00
BODILY INJURY (Per person)
$
BODILY INJURY (Per accident)
$
PROPERTY DAMAGE
$
Com GD
$ 120 000
B
X
UMBRELLA LIAR
EXCESS LIAR
X
OCCUR
CLAIMS -MADE
S055535180
/28/2013
0/01/2013
EACH OCCURRENCE
$ 1,000,00 00
AGGREGATE
$ 1,000,000
DED X RETENTION$ 10,00
$
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITYYIN
ANY OFFIC RIMEIMBER EXCLUDED? ECUTIVE
(Mandatory In NH)
If yes, desonloe under
DESCRIPTION OF OPERATIONS Del.
NIA
VvG STATU- OTH-
I 9
E.L. EACH ACCIDENT
$
E.L. DISEASE - EA EMPLOYEE
$
E.L. DISEASE- POLICY LIMIT
$
DESCRIPTION OF OPERATIONS I LOCATIONS VEHICLES (Athch ACORD 101, Additional Remarks Schedule, Rmom space Is required)
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
City of Fort Collins
PO Box 580
Fort Collins, CO 80522 AUTHORIZED REPRESENTATIVE
Madron/SLB S&Az� M rvl 1 --
(c119RR.2n1n ACORD CORPORATION. All rights reserver
INS025 (201005).01 The ACORD name and logo are registered marks of ACORD