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HomeMy WebLinkAbout104002 COLORADO IRON AND METAL - INSURANCE CERTIFICATECOIRO-1 OP ID: JD A`oizo CERTIFICATE OF LIABILITY INSURANCE DATE 08130/13/30/13 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 Phone: 970.482-7747 Brown 5 Brown Inc 4532 Boardwalk Dr, Suite 200 Fax: 970-484-4165 Fort Collins, CO 80525 Tyler B. Allen CONTACT NAME. _ PHONE N E-MAIL - ADDRESS: _ INSURE 8 AFFORDING COVERAGE NAIL B INSURER A:PInnacolAssurance Company 41190 INSURED Colorado Iron and Metal 903 Buckingham /0 002 Ft Collins, CO 80524 INSURER B: National Specilalty Ins Co 226M INSURER C INSURER D : 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 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. LM N ME OF INSURANCE WEL POLICY NUMBER DMIYY FF IDIVYXYY LIMITS 8 GENERAL LIABILITY X COMMERCIALGENERALLMMUTY CLAIMS4&41)E FXI OCCUR CWN021600102 09101113 09101114 EACH OCCURRENCE $ 1,000,00 -DAMAGE P MISE-S IEa ocw dote $ 300,00 NEED EXP(My one person) S 15,00 PERSONAL A ADV INJURY S 1,000,00 GENERALAGGREGATE $ 2,000,00 GENL AGGREGATE POLICYFX1 OMIT APPLIES PER: JFCT PRO- LCC PRODUCTS -COMPAOP AGG $ 2.000,00 S B AUTOMOBILE LIABILITY _ X ANYAUTO ALL OWNED SCHEDULED AUTOS AUTOS NON-CHIRED AUTOS AUTOS �ED SKNO21600102 09/01/13 09/01/14 SINGLECOMBINED IMI Ea Sodden 1,000,00 BODILY INJURY (Per Pension) S BODILY INJURY (Per acoiderd) $ PerOPERT � AMAGE $ S g X UMBRELLA LMB I EXCESS LIAB X OCCUR a(a.NMs+eAOE C KN021600102 09101/13 09/0111114 EACH OCCURRENCE S Z000,000 AGGREGATE S 2,000,00 DIED I X I RETENTIONS 0 $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETORIPARTNERIEXECUTNEYIN OFFICERrMEMBER EXCLUDED? (Mandatory In NH) N yes IPTIOe F OO DESCRRIPTION OF OPERATIONS berow NIA 3333756 06101/13 OW01/14 X WC STATU- TRH - TOW I PE F.L.EACH ACCIDENT S 500,00 E.L. DISEASE -EA EMPLOYEE $ 500,00 EL dSEASE-POLICY LIMIT 560100 8 Leased/Rentd Equip CWN021600102 0910111IT7 Limit 150,00 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks SchedWa, BMaa aPaee 4 raRelred) Fea:: 530-0301 City of Fort Collins Natural Resources Department 281 N College Avenue Fort Collins, CO 80522 FTCNATR 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 ©1988.2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD ----1 COIRO-1 OP ID: JD 14lll. E31 CERTIFICATE OF LIABILITY INSURANCE DAT08/30D/YVYY) 08/30l13 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 PRODUCER Phone: 970-482-7747 Brown & Brown Inc Fax: 970-484-4165 4532 Boardwalk Dr, Suite 200 Fort Collins, CO 80525 Tyler B. Allen LUNTAUI NAME -- FAX Mo 1 _ AR No: -NAIL ADDRESS: !INSURERS), AFFORDING COVERAGE _ INSURER A: Pinnacol Assurance Company 411 INSURED Colorado Iron and Metal / O 2 903 Buckingham 0 F#Cnlline rn RAR9d INSURER a: National SpecialtyIns Co 226 INSURER C: COVERAGES CFRTIFICATF NtIMRFR- RFVISIflN NIIMRPR. 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. INSR LTR TYPE OF INSURANCE POLICY NUMBER MWDOhYYY MMMD MYY LIMIT B GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAMS -MADE � OCCUR CWN021600102 09101/13 09/01114 EACH OCCURRENCE 3 11000,00 PREMISES EsoccunmGe $ 300,00 NED UP (My one peritn) $ 15,00 PERSONAL S ADV INJURY $ 1.000,00 GENERAL AGGREGATE $ 2,000,00( GEN% AGGREGATE LIMIT APPLIES PER: JECT POLICY X PRO -LAC PRODUCTS-COMP/OP AGG $ 2,000r00 $ B AUTOMOBILE LIABILITY ANYAUTD AOSCHEDULED AUUTOSS AUTOS NON -OWNED HIRED AUTOS AUTOS BKN021600102 09/01/13 0910'1/14 COMBINED IN LIMI Ea accdent 1.000r00 BODILY INJURY (Par paean) S J BODILY INJURY (Per accident) S PROPERLY DAMAGE Per acGden1 $ $ B X UMBRELLA LIAR EXCESS LIAe X OCCUR S-IM CLAIMDE KN021600102 09/01/13 09/01/14 EACH OCCURRENCE S 2,000,00 AGGREGATE $ 2,000,00 OED X RETENTIONS 0 S A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNERrEXECUTIVE YIN OFFICERNIEMBER EXCLUDED? ❑ (Mandatory In NH) Byyeass gouge. name DESCRIPTION OF OPERATIONS eelvv 333756 06101/13 06/01114 X WC STATU• TH- S ER ER E.L.ACH ACCIDENT E.L.MIA $ 500,00 E.L.DISEASE-EA EMPLOYE S 50010 E.L.DISEASE - POLICY LIMIT S Soo, B Leased/Rend Equip TCWN021600102 09/01113 09101M4 Limit 150,00 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (AUach ACORD 101, Additional Romania SchaduM.11exaeapaceM npWrod) FTCNATR City of Fort Collins Natural Resources Department 281 N College Avenue 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 q� All rights reserved ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD