HomeMy WebLinkAbout103118 KWAL-HOWELLS INC - INSURANCE CERTIFICATE (3)0
ACC> V CERTIFICATE OF LIABILITY INSURANCE
1661
DATE
12/18/2013Yv
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 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).
A'yI'an�lbroup - Cleveland
6000 Freedom Square Drive
Co NTACT
Sall Harper
PNAME HONE FAx
216-447-1050 c 216-447-4088
E-MAIL RESS: Sally.Harper@Hylant.com
Suite 400
Cleveland, OH 44131
INSURERS AFFORDING COVERAGE
NAICI
INSURER A:National Union Fire Insurence Co. of PlItsburgh, PA
19445
INSURED 2
Kwal-Howells, Inc. I031 Vmay/
INSURER B:
INSURERC:XL Specialty Insurance Co.
37885
INSURER D:
5575 DTC Parkway, Suite 100
INSURERE:
Englewood, CO 80111 C T-1
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.
INSR
RMM
TYPE OF INSURANCE
ADDL
SUER
POLICY NUMBER
POLICY EFF
POLICY E)yY
LIMITS
A
GENERAL LIABILITY
X COMMERCIAL GENERALLIABILITY
CLAIMS-MADEIT] OCCUR
GL5094663
GL5094664
12/16/13
12/16/13
06/01/16
05/01/16
EACH OCCURRENCE
f 1,000,000
DANIA ERENTE nce
s 1,000,000
MED EXP (Any one person)
f
PERSONAL &ADV INJURY
S 100010 0
GENERAL AGGREGATE
$ ,000
GEN'L AGGREGATE
X POLICY
LIMIT APPLIES PER:
PRO. LOC
JFCT
PRODUCTS - COMP/OP AGG
S 110001000
EA OCC PRODCOMP/OP
$ 1,000,000
A
A
A
AUTOMOBILE LIABILITY
X ANY AUTO
X ALL OWNED SCHEDULED
NONAWNED
X HIRED AUTOS AUTOS
CA5196415 (AOS)
CA5196416 (MA)
CA5196417(VA)
12/16/13
12/16/13
12/16/13
05/01/16
05/01/16
05/01/16
a°eBINED SINGLE LIMB
1,000,000
BODILY INJURY (Per person)
S
BODILY INJURY (Per accident)
$
PROPERTY DAMAGE
Peracc' I
$
S
UMBRELLA LIAB
EXCESS LIAB
7
OCCUR
CLAIMSMADE
EACH OCCURRENCE
f
AGGREGATE
IS
DED I I RETENTIONS
EA OCC PROD/COMP OP
s
C
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY YIN
OANY
FFICEOPRIETEREXCLUDEDWE ECUTIVE
(Mandatory in NH)
I! yes descrlbe under
DESCRIPTION OF OPERATIONS below
N/A
RWD943514809
09/01/13
03/01/14
WCSTATU- OTH&
E.L. EACH ACCIDENT
$ 1,000r000
E.L. DISEASE - EA EMPLOYEE
f 1,000,000
E.L. DISEASE -POLICY LIMIT
S 1,000,000
DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space is re wired)
ALL LOCATIONS AND OPERATIONS OF THE NAMED INSURED AND ITS DIVIS�ONS IN ALL STATES
Re: Renewal, 6043 Mapo Athletic Field Paint. Certificate Holder Is Additional Insured As Respects General Liability Where
Required By Written Contract.
CERTIFICATE HOLDER CANCELLATION
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
215 North Mason Street, 2nd Floor
AUTHORIZED REPRESENTATIVE
PO Box 580
Fort Collins CO 80522-0580
C 1988-2010 ACORD CORPORATION. All rights reserved.
ACORD 25 (2010/05)
The ACORD name and logo are registered marks of ACORD
MURM
Kwal-Howells, Inc.
OF NAMED INSUREDS
AEX NORTH AMERICA, INC. F/K/A COMEX GROUP, INC.
AEX GROUP, INC.
)FESSIONAL PAINT, INC.
ZEE INDUSTRIES HOLDINGS, INC.
ZEE INDUSTRIES, INC.
%L-HOWELLS HOLDINGS, INC.
%L-HOWELLS, INC.
IKER PAINT HOLDINGS, INC.
;KER PAINT MFG. CO., INC.
ZEE FRANCHISE CORP.
ILLAR PAINT (DBA)
'HIR MORRIS HOLDINGS, INC.
ACQUISITION CORP.
SOPHIR COMPANY
LLAR KWAL PAINT (DBA)
LLAR ACQUISITION CORP.
LLAR HOLDINGS, INC.
:KBACK ACQUISITION CORP.
;KBACK PRODUCTS (DBA)
;KBACK HOLDINGS, INC.
,SSIC PAINT (DBA)
4L PAINT (DBA)
4L PAINTS (DBA)
AEX USA, INC.
VDERHORN ACQUISITION CORP.
LLAR ACQUISITIONS DBA AMERIMEX PAINT CENTERS
.OR WHEEL PAINT MFG. CO., INC.
.OR WHEEL PAINTS AND COATINGS
.OR WHEEL PAINTS
! PAINT STORE
.OR WHEEL DECORATING CENTER
TUBE PROPERTIES, LTD.
TUBE HOLDINGS, INC.
.OR WHEEL ACQUISITION CORP.
.OR WHEEL HOLDINGS, INC.
AEX GROUP IP, INC.
AEX ENVIRONMENTAL GROUP, INC.
RESPECTS PRODUCTS SOLD IN THE UNITED STATES
CERTIFICATE HOLDER:
DATE
12/18/2013
CERTIFICATE OF LIABILITY INSURANCE
DATE (
12/18/2013YY)
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).
POy[ani%roup - Cleveland
CONTACT
Sally Harper
PHONE FAX
216-447-1050 216-447-4088
6000 Freedom Square Drive
n uR s: Sally.HarperoHylant.com
Suite 400
Cleveland, OH 44131
INSURERP AFFORDING COVERAGE
NAIL!
INSURER A :Natlonal Union Fire Insurance Co. of PrftbuMh, PA
19445
INSURED
Kwal-Howells, Inc.
INSURER B :
INSURERC XL Specialty Insurance Co.
37885
INSURER D:
5575 DTC Parkway, Suite 100
INSURER E:
Englewood, CO 80111 C.` T-1
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.
INSR
LTR
TYPE OF INSURANCE
J L
SUER
POLICY NUMBER
FMLICY EFF
POLICY Y EXP
LIMITS
A
GENERAL LIABILITY
COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE ® OCCUR
GL5094663
GL5094664
12/16/13
12/16/13
05/01/16
05/01/16
EACH OCCURRENCE
{ 1,000,000
PR A E e N%o c
f 1,
MED EXP (Any one .)
$
PERSONAL f ADV INJURY
f 1,000,000
GENERAL AGGREGATE
f 110
GEN'L AGGREGATE
,X7 POLICY
LIMIT APPLIES PER:
PRO.LOC
PRODUCTS - COMP/OP AGG
$ 1.2010 0
EAOCCPRODCOMPIOP
f 1,000,000
A
A
A
AUTOMOBILE LIABILITY
X ANY AUTO
X ALL OWNED SCHEDULED
X HIRED AUTOS X NON -OWNED
AUTOS
CA5196415 (ADS)
CA5196416 (MA)
CA5196417(VA)
12/16/13
12/16/13
12/16/13
05/01/16
05/01/16
05/01/16
COMOINNEEO SINGLE LIMIT
1,000,000
BODILY INJURY(P. person)
f
BODILY INJURY(Per accIdenQ
f
PROPERTY DAMAGE
$
f
UMBRELLA LIAB
EXCESS LIAB
OCCUR
CLMMSAMDE
EACH OCCURRENCE
$
AGGREGATE
S
DED I I RETENTIONS
EA OCC PROD/COMP OP
S
C WORKERS COMPENSATION
ANDEMPLOYERS' LIABILrY YIN
ANY PROPRIETOWPARTNEWEXECUTIVE
OFFICER/MEMBER EXCLUDED? N❑
(MYyaer5dwary m NH)
DESCRIPTsTIo OF aelov.
NIA
RWM3514809
09/01/13
=01/14
X I &sTATu I I oTH-
E.L. EACH ACCIDENT
f 1,000,000
E.L. DISEASE - EA EMPLOYE
S 1,000,000
E.L. DISEASE -POLICY LIMIT
I S 1,000,000
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Apet11 ACORD 101, Additional Remarks Schedule, of more space is required)
ALL LOCATIONS AND OPERATIONS OF THE NAMED INSURED AND ITS DIVISIONS IN ALL STATES
The City Of Fort Collins Is An Additional Insured As Their Interest May Appear As Respects General Liability Where Required By
Written Contract.
City of Fort Collins
Attn: John Stephen, CPPB, Senior Buyer
PO Box 580
215 North Mason Street, 2nd Floor
Fort Collins CO 80522-0580
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 //--
rIflMC rPSPNPd.
ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD
INSURED
Kwal-Howells, Inc.
1EDULE OF NAMED INSUREDS
AEX NORTH AMERICA, INC. F/K/A COMEX GROUP, INC.
AEX GROUP, INC.
)FESSIONAL PAINT, INC.
ZEE INDUSTRIES HOLDINGS, INC.
ZEE INDUSTRIES, INC.
aL-HOWELLS HOLDINGS, INC.
kL-HOWELLS, INC.
;KER PAINT HOLDINGS, INC.
;KER PAINT MFG. CO., INC.
ZEE FRANCHISE CORP.
LLAR PAINT (DBA)
IHIR MORRIS HOLDINGS, INC.
ACQUISITION CORP.
SOPHIR COMPANY
LLAR KWAL PAINT (DBA)
LLAR ACQUISITION CORP.
LLAR HOLDINGS, INC.
:KBACK ACQUISITION CORP.
:KBACK PRODUCTS (DBA)
:KBACK HOLDINGS, INC.
SSIC PAINT (DBA)
%L PAINT (DBA)
%L PAINTS (DBA)
AEX USA, INC.
VDERHORN ACQUISITION CORP.
LLAR ACQUISITIONS DBA AMERIMEX PAINT CENTERS
.OR WHEEL PAINT MFG. CO., INC.
.OR WHEEL PAINTS AND COATINGS
.OR WHEEL PAINTS
PAINT STORE
.OR WHEEL DECORATING CENTER
UBE PROPERTIES, LTD.
UBE HOLDINGS, INC.
.OR WHEEL ACQUISITION CORP.
OR WHEEL HOLDINGS, INC.
AEX GROUP IP, INC.
AEX ENVIRONMENTAL GROUP, INC.
RESPECTS PRODUCTS SOLD IN THE UNITED STATES
DATE
12/18/2013
AC40 o® CERTIFICATE OF LIABILITY INSURANCE
12/18/2o 3""
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
holder in lieu of Such endorsement(s).
�fjcertificate
1'1yyDPaf;tgroup - Cleveland
6000 Freedom Square Drive
Suite 400
cNTEAcT
Sall Harper
ioxe FAX
216-447-1050 Nick 216-447-4088
EialL Sally.HarperOHylant.com
Cleveland, OH 44131
INSURER AFFORDING COVERAGE
NAIC!
INSURER A :National Union Flm Insurance Co. of Pittsburgh, PA
19445
INSURED
Kwal-Howells, Inc.
INSURER e :
INSURER c:XL Spedafty Insurance Co.
37865
INSURER D:
5575 DTC Parkway, Suite 100
INSURENSURER R
Englewood, CO 80111 C T-1
FE:
I
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.
INSR
TYPE OF INSURANCE
ADDL
SUER
POLICY NUMBER
POLICY EFF
POLICY EXP
LIMITS
A
GENERAL LIABILITY
X COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE OCCUR
GL5094663
GL5094664
12/16/13
12/16/13
05/01/16
05/01/16
EACH OCCURRENCE
f
Nn Es Eacceurann
s 1,000,000
MED EXP ono )
f
PERSONAL A ADV INJURY
f ,000
GENERAL AGGREGATE
f 0,000
GENT AGGREGATE
X POLICY
LIMIT APPLIES PER:
PRO LDC
PRODUCTS COMP/OPAGG
f , 01000
EAOCCPRODCOMPJOP
f 1,000,000
A
A
A
AUTOMOBILE LIABILITY
X ANY AUTO
X A�SNED SCHEDULED
OS
NON -OWNED
X HIRED AUTOS qAUTOS
CA5196415 (ADS)
CA5196416 (MA)
CA5196417 (VA)
12/16/13
12/16/13
12/16/13
05/01/16
05/01/16
05/01/16
COMBIED ItssccMe " LIB
1000000
BODILY INJURY (Par peran)
f
BODILY INJURY (Per amen 1
f
PROPERTY DAMAGE
(Per accialffla
p
s
UMBRELLA LIAB
EXCESS LIAB
OCCUR
ClA1MS-MADE
EACH OCCURRENCE
f
AGGREGATE
f
DIED I I RETENTION f
EA OCC PROD/COMP OP
f
C
WORKERS COMPENSATION
AND EMPLOYERS' LWBILmf Y/N
OMY
FFICEOPRIETEREXCWDED?ECUTIVE
(Myaensdwtory in NH)
DESCRIPTION ON OF OPERATIONS W.
N/A
RWD943514809
09t01/13
03/01/14
X I % sTATD. OTH.
UNITS
E.L EACH ACCIDENT
f 1,000,000
E.L. DISEASE - EA EMPLOYE
f 1,000,000
E.L. DISEASE POLICY LIMIT
I S 1,000,000
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additimel Ramarks Schedule, if more space Is required)
ALL LOCATIONS AND OPERATIONS OF THE NAMED INSURED AND ITS DIVISIONS IN ALL STATES
The City, Its Officers, Agents And Employees Is An Additional Insured As Respects General Liability Coverage, Only As
Required By Contract, Subject To The Terms And Conditions Of The Policy.
CERTIFICATE HOLDER CANCELLATION
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
Attn: Purchasing and Risk
AUTHORIZED REPRESENTATIVE
PO Box 580
r
Fort Collins CO 80522
0 1988-2010 ACORD CORPORATION. All rights reserved.
ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD
INSURED
Kwal-Howells, Inc.
OF NAMED INSUREDS
AEX NORTH AMERICA, INC. F/K/A COMEX GROUP, INC.
AEX GROUP, INC.
)FESSIONAL PAINT, INC.
ZEE INDUSTRIES HOLDINGS, INC.
ZEE INDUSTRIES, INC.
4L-HOWELLS HOLDINGS, INC.
4L-HOWELLS, INC.
tKER PAINT HOLDINGS, INC.
tKER PAINT MFG. CO., INC.
ZEE FRANCHISE CORP.
:LLAR PAINT (DBA)
'HIR MORRIS HOLDINGS, INC.
ACQUISITION CORP.
SOPHIR COMPANY
:LLAR KWAL PAINT (DBA)
ILLAR ACQUISITION CORP.
LLAR HOLDINGS, INC.
:KBACK ACQUISITION CORP.
:KBACK PRODUCTS (DBA)
:KBACK HOLDINGS, INC.
,SSIC PAINT (DBA)
4L PAINT (DBA)
4L PAINTS (DBA)
AEX USA, INC.
VDERHORN ACQUISITION CORP.
.LLAR ACQUISITIONS DBA AMERIMEX PAINT CENTERS
.OR WHEEL PAINT MFG. CO., INC.
.OR WHEEL PAINTS AND COATINGS
.OR WHEEL PAINTS
PAINT STORE
.OR WHEEL DECORATING CENTER
:UBE PROPERTIES, LTD.
TUBE HOLDINGS, INC.
.OR WHEEL ACQUISITION CORP.
.OR WHEEL HOLDINGS, INC.
AEX GROUP IP, INC.
AEX ENVIRONMENTAL GROUP, INC.
RESPECTS PRODUCTS SOLD IN THE UNITED STATES
CERTIFICATE HOLDER:
DATE
12/18/2013
CERTIFICATE OF LIABILITY INSURANCE
DATE (MMIDDNY
12/18/2013Y)
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).
Pe0IIa000tH,�
lbJroup -Cleveland
II''11yy00
NAME CT Sall Harper
PHn ONE 21g-447.1050 Fa"c No), 216-447-4088
60Freedom Square Drive
n oRIL 5, Sally. Haer H lant.com
Suite 400
Cleveland, OH 44131
INSURE S AFFORDING COVERAGE
NAICk
INSURER A :Nafional Union File Insurance Co. of Pittsburgh, PA
19445
INSURED
Kwal-Howells, Inc.
INSURER B :
INSURERC:XL Specialty Insurance Co.
37885
INSURERD:
5575 DTC Parkway, Suite 100
INSURER E.
Englewood, CO 80111 C T-1
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.
INSR
LTR
TYPE OF INSURANCE
ADDL
SUER
POLICY NUMBER
FEE
MMIDPOLICOM/YY
POLICY P
MMIDDIYYYY
LIMITS
A
GENERAL LIABILITY
COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE ®OCCUR
GL5094663
GL5094664
12/16/13
12/16/13
05/01/16
05/01/16
EACH OCCURRENCE
S1,000,000
DPREVISESAmAGE RENTED
$ 1,000,000
MED EXP (Any one on)
f
PERSONAL &ADV INJURY
f 1,000,000
GENERAL AGGREGATE
f 1+
GEN'L AGGREGATE
X POLICY
LIMIT APPLIES PER:
PRO. LOC
JECT
PRODUCTS - COMP/OP AGO
$ 1,000,000
E DicePRODCOMPIOP
f 1,000,000
A
P`
A
AUTOMOBILE LIABILITY
X ANY AUTO
XALL AUTOS NED ;CHEDULED
NONAUT .WNED
X HIRED AUTO$ AUTO$
CA5196415(AOS)
CA5196416 (MA)
CA5196417 (VA)
12/16/13
12/16/13
12/16/13
05/01/16
05/01/16
05/01/16
COMBINED SINGLE LIMIT
1000000
BODILY INJURY(Pa pawn)
f
BODILY INJURY (Per accidant)
f
PROPERTY DAMAGE
Pa acciden
f
f
UMBRELLA UAB
EXCESS LIAR
OCCUR
CLA:MADE
EACH OCCURRENCE
f
AGGREGATE
$
OEO RETENTIONSI
I EA OCC PROD/COMP OP
I f
C
WORKERS COMPENSATION
AND EMPLOYERS'LIABILITY YIN
ANY PROPRIETORIPARTNEWEXECUTIVE ®
OFFICER/MEMBER EXCLUDED?
(mandatory In NH)
DESEiJearriltainal
PTION OF OPERATIONS below
NIA
RWD943514809
09/01/13
03/01/14
X WC STATU- OTH-
E.L. EACH ACCIDENT
f 1,000,000
E.L. DISEASE - EA EMPLOYE
f 1,000,000
E.L. DISEASE -POLICY LIMIT
f 1,000,000
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required)
ALL LOCATIONS AND OPERATIONS OF THE NAMED INSURED AND ITS DIVISIONS IN ALL STATES
City Of Fort Collins Is Additional Insured As Respects General Liability Where Required By Written Contract. Term Has Been
Extended From April 15, 2011 Through April 14, 2012.
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
Attn: Director of Purchasing and Risk Management
PO Box 580
Fort Collins CO 85022
h
reserved.
ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD
INSURED
Kwal-Howells, Inc.
OF NAMED INSUREDS
4EX NORTH AMERICA, INC. F/K/A COMEX GROUP, INC.
AEX GROUP, INC.
IFESSIONAL PAINT, INC.
ZEE INDUSTRIES HOLDINGS, INC.
ZEE INDUSTRIES, INC.
\L-HOWELLS HOLDINGS, INC.
\L-HOWELLS, INC.
.KER PAINT HOLDINGS, INC.
,KER PAINT MFG. CO., INC.
ZEE FRANCHISE CORP.
LLAR PAINT (DBA)
'HIR MORRIS HOLDINGS, INC.
ACQUISITION CORP.
SOPHIR COMPANY
LLAR KWAL PAINT (DBA)
LLAR ACQUISITION CORP.
LLAR HOLDINGS, INC.
:KBACK ACQUISITION CORP.
:KBACK PRODUCTS (DBA)
:KBACK HOLDINGS, INC.
SSIC PAINT (DBA)
1L PAINT (DBA)
\L PAINTS (DBA)
lEX USA, INC.
VDERHORN ACQUISITION CORP.
LLAR ACQUISITIONS DBA AMERIMEX PAINT CENTERS
OR WHEEL PAINT MFG. CO., INC.
OR WHEEL PAINTS AND COATINGS
OR WHEEL PAINTS
PAINT STORE
OR WHEEL DECORATING CENTER
UBE PROPERTIES, LTD.
UBE HOLDINGS, INC.
OR WHEEL ACQUISITION CORP.
OR WHEEL HOLDINGS, INC.
1EX GROUP IP, INC.
1EX ENVIRONMENTAL GROUP, INC.
RESPECTS PRODUCTS SOLD IN THE UNITED STATES
CERTIFICATE HOLDER:
DATE
12/18/2013