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HomeMy WebLinkAbout107133 BATH INC - INSURANCE CERTIFICATE (3)Client#: 21043 BATIN ACORD... CERTIFICATE OF LIABILITY INSURANCE D312ATE YY) 012014 3/20/2014 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). PRODUCER NOMTA NAcT Jennifer Winter E: N Flood & Peterson Ins., Inc. PHONE g70 506-3206 FAX WIN Eat : uc, No : 970 506-68" P. O. Box 578 ADDRESS: JWinter oodpeterson.com ADDRESS: Greeley, CO 80632 INSURER(S) AFFORDING COVERAGE NAlti 970356-0123 Bit INSURER A: Bituminous Insurance 20095 INSURED INSURERS: St. Paul Fire & Marine Ina. Co. 24767 Bath, Inc. 09 133 INSURER C: PInnaCOl Assurance 41190 2000 E. Prospect Road Fort Collins, CO 80525 InsuRERD: 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 CONTRACTOR 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. �TRR TYPE OF INSURANCE NSRL SUBR WVD POLICY NUMBER POLICY INlDI DYfOE'YY MM/UUY EXP LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE O OCCUR X PDDed:500 CLP3595079 11/0112013 11/01/2014 $1000000 pEppApCCMHpp��OEEC7C7URRRREEENCE PREMISES Eeomnrence 5100000 MED EXP we Rehm) § 10 000 PERSONAL BADVINJURY $1000,000 GENERAL AGGREGATE s2,000,000 GII AGGREGATE LIMIT APPLIES PER: POLICY X PET LOC PRODUCTS-COMP/OP AGO E2000000 § A AUTOMOBILE LIABILITY YAUTO OWNED SCHEDULED TOSAUTOS JA ED AUTOS X AUTOS a Olh Car CAP3595080 11/01/2013 11/0112014 EOMaBIINEDSINGLELIMIT 1r000,000 BODILY INJURY(Perperson) S BODILY INJURY(Per accident) § (Par Evident) GE§ S A B X X UMBRELLALWB EXCESS LLAB X OCCUR I CLAIMS -MADE CUP2803536 ZUP13T9187713NF 1101/2013 1/01/2013 111011"2014 1110112014 EACHOCCURRENCE §1000000 AGGREGATE §1 000 000 I DED I X RETENTION§10000 Ea Occur s4,000,000 `+ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOWPARTNER/EXECUTIVE YIN OFFICERIMEMBER EXCLUDED? � (Mandatory In NH) DIf ESCRIPTION under OF OPERATIONS W . AIA 4015110 1/01/201311/01/201 XWC STATU- OTH- E.L. EACH ACCIDENT §1 OOO OOO E.L. DISEASE - EA EMPLOYEE $1 000 000 E.L. DISEASE -POLICY LIMIT $1 000 000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space is required) RE: South Transit Center, 4915 Fossil Blvd., Fort Collins, CO 80525 City of Fort Collins, its officers, agents and employees, are listed as Additional Insureds as their interest may appear as respects General Liability, including completed operations. Insurance is primary and non-contributory. City of Fort Collins PO 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 ACORD 25 (2010105) 1 of 1 #S871296/M837496 © 1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD JZS