HomeMy WebLinkAbout340571 MAX FIRE APPARATUS INC - INSURANCE CERTIFICATE (6)MAXFI-1 OP ID: SEA
,a%%. R CERTIFICATE OF LIABILITY INSURANCE
DATEIMMI
11113l2013
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 pollcy(les) 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 Ileu of such endorsements .
PRODUCER
CRS Insurance Brokerage
Commercial Risk Solutions DBA
6600 E. Hampden Ave.
Denver, CO 80224
Sherry A. McGann
CONTACT
NAME_
PHONE FAX
a No AIC No:
ADOR
ADDRESS:
INSURERS) AFFORDING COVERAGE NAIC8
INSURERA: Hartford Insurance Company 22357
INSURED Max Fire Apparatus, Inc. 34o5`I I
Max Fire Apparatus, LLC.
P.O. Box 1658
ImumRB:PinnacolAssurance
INeuRERc:
Castle Rock, CO 80104
INSURER D:
INSURER E :
INSURER F
COVERAace CFRTiRCATF 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 MAYHAVE BEEN REDUCED BY PAID CLAIMS
LTR
TYPE OF INSURANCE
POLICY NUAER
(NIM MMIDD/YYYY
LIMITS
A
GENERAL LIABILITY
X COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE �X OCCUR
X
34UUNQ08093
11/01/2013 11/012014
EACH CCCUWENCE
f 1,000,00
PREMISES(Ea occummce
S 300,00
NEDEXP(Any weperson)
t 10,00
PERSONAL B AOV INJURY
f 1,000,00
GENERAL AGGREGATE
s 2,000,00
GEN'L AGGREGATE-IMIT
X POLICY
APPLIES PER:
PR LOC
PRODUCTS - COMPIOPAGG
t 2,000,000
$
A
AUTOMOBILE LIABILITY
X ANY AUTO
ALL OWNED SCHEDULED
AUTOS AUTOS _
X HIREL AUTOS X AUTOSWN�
34UUNQ08093
11101/2013 111012014
Ee accident .
1,000,00
BODILY INJURY (Per person)
f
ODDLY INJURY (Per ac:ideu
$
A
PEA ACCIDENT)f
f
A
X
UMBRELLALW
EXCESSLue
X
OCCUR
CLAIMS.MADE
34HH0008094
11/01/2013 11/012014
EACHCCCURRENCE
$ 1,000,00
AGGREGATE
t 1,000,00
DED X RETENTIONS 10000
S
B
WOR<ERS COMPENSATION
AND EMPLOYERS'LIANUTY
ANY PROPRIETOWYPRTVERIE)0=CU11VE YIN
0FFICERMIEMBER EXCWCED" �
(Mandatory h NH)
If yes, describe under
DESCRIPTION OF OPERATIONS MIrn
NIA
077375
02/01/2013 02/01/2014
X
EL EACH 4CLICENi
S 100,ODC
E.L. DISEASE. EA EMPLOYEE
S 100,00
E.L. DISEASE POLICY LIMIT
S SDDr
DESCRIPTION OF OPERATIONS 1 LOCATIONS I VEHICLES (Aduh ACORD 101, Addilontl Remark. Schedule, If mom apace to required)
Fleet Maintenance. City of Fort Collins is included as additional
insured on the General Liability with respect to ongoing operations of the
n,alned insured for the certificate holder as required by written contract.
1 policy terms, conditions and exclusions apply.
CIFORTC
City of Fort Collins
P.O. 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
CORPORATION. All rights reserved.
ACORD 25 (2010t05) The ACORD name and logo are registered marks of ACORD