HomeMy WebLinkAboutFORT COLLINS TOWING LLC - INSURANCE CERTIFICATEACCI �®
l`/,R CERTIFICATE OF LIABILITY INSURANCE
DATE IMMIDD YYYY)
12/12/2013
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(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 endorsements).
PRODUCER
JOHN C. BECKETT 6 ASSOCIATES, INC.
220 Smith Street
Ft. Collins CO 80524-
CONTACT
NAME'
PHONE (970) 484-2805 FAx . (970) 484-2885
EMAIL . lincla@beckettinsurance. com
INSURERS AFFORDING COVERAGE
NAIC P
INSURERA:PINNACOL ASSURANCE CO.
INSURED Fort Collins Towing, LLC
1617 1/2 E Mulberry St
Larimer
Fort Collins CO 80524-
INSURER 8:
INSURER C:
NSURER D:
INSURER E
INSURER F:
rvo Tlvlr vC ul Macco. RFVISIr1N NI IMRFR•
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
ADM
SUER
POLICY NUMBER
POLICY EFF
POLICY EXP
LIMITS
GENERAL LIABILITY
O COVERAGE
/ /
/ /
EACH OCCURRENCE
S
DAMAGE 10 E
PREMISE Ea occurrence
$
COMMERCIAL GENERAL LIABILITY
/ /
/ /
MED EXP(My one person)
$
CLAIMS -MADE 7 OCCUR
/ /
/ /
PERSONAL S ADV INJURY
$
GENERAL AGGREGATE
$
/ /
/ /
GEN'L AGGREGATE
LIMIT APPLES PER:
PRODUCTS-COMP/OP AGO
$
$
POLICY
F7 PRO- 7 LOC
JFCT
/ /
/ /
AUTOMOBILE LIABILITY
NO COVERAGE
/ /
/ /COMBINED
SINGLE
Ea accidera
BODILY INJURY (Per Person)
$
ANY AUTO
/ /
/ /
BODILY INJURY (Per accidenl)
$
ALL OWNED SCHEDULED
AUTOS AUTOS
NON —OWNED
HIRED AUTOS PAUTOS
/ /
/ /
/ /
/ /
PROPER? DAMA E
Per a. rt
$
UMBRELLA LIAB
OCCUR
O COVERAGE
/ /
/ /
EACH OCCURRENCE
$
EXCESS UAB
CLAIMS -MADE
/ /
/ /
AGGREGATE
S
DELI I I RETENTION
/ /
/ /
$
A
WORKERS COMPENSATION
4127345
1/01/2013
1/01 2014
X WC STATU- OTH-
AND EMPLOYERS'UASIUTY YIN
ANY PROPRIETORIPARTNER/EXECUTIVE
OFFICER/MEMBER EXCLUDED?
(Mandatary In NH)
NIA
/ /
/ /
/ /
/ /
E.L. EA CH ACCIDENT
$ 100000
E"".L DISEASE - EA EMPLOYE
$ 100000
E.L. DISEASE -POLICY LIMIT
S 500000
If yea, describe under
DESCRIPTION OF OPERATIONS Wlcw
O COVERAGE
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Aeach ACORD 101, Additional RemaMs Schedule, d ruee Mm" Is required)
CITY OF FORT COLLINS
215 N MASON ST
FORT COLLINS
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 RgfRESENTATIVE
CO 80524- -Ay[.s'._.• ,1`-+c'__.....•t.._.._.--�--
® 1988-2010 ACORD CORPORATION. All rights reserved.
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