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Home My WebLink About126796 HARMONY GREASE MONKEY & CAR WASH - INSURANCE CERTIFICATE (2)OP ID: SC atc.�o�zi� CERTIFICATE OF LIABILITY INSURANCE 1 °A0a10``v14ta 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 970-223-1804 CONTACT NAME: Front Range Insurance Group 1100 Hatton Drive Sulte 100 Fort Collins, CO 80525 David A. Wooldridge LUTCFAAI PHONE E E - ----- -- X �: - ASS: CUSTOMER ID S: PROAU4 AFFORDING COVERAGE NAIC s INSURED Pro Auto Lube & Wash Inc. / MAMMA: Cincinnati Insurance Companies 10677 dba Harmony Grease Monkey & 124196 WBUREts: Pinnacol Assurance 41190 Car Wash 1036 Oakridge Fort Collins, CO 80525 ITSURER C: INSURERO: -- INSURERS: INSIdtER 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 LTRTYPE OF INSURANCE POLICY NUMBER MMDDIYYYY LIMITS A GENERALLIASWTY X COMMERCIAL GENERAL LIABILITY CLAMS.MADE FXI OCCUR X ECP0190528 04/30114 04130/15 IS EACH OCCURRENCE $ 1,000, PREMISES LE@ occur S 100, 000 MED BQ' (My we reon S 10, 000 PERSONAL & ADV INJURY E 1,000, GENERAL AGGREGATE S 2,000'00( GEN'L AGGREGATE POLICY LIMIT APPLIES PER: PRO- LOC JFCTX PRODUCTS - COMPIOP AGG S $000r 00( A A AUTOMOBILE LIABILITY ANY AUTO ALLOWNEOAUTOS SCHEDULED AUTOS HIRED AUTOS NON-OWNEDAUTOS Garage Keepers X ECP0190528 ECP0190528 ECP0190528 0413OM4 04/39M4 04/3OM4 04/3N45 04/3OM5 OU36MS COMBINED SINGLE LIMIT (Es acaden0 S 1000, ' BODILY INJURY (Per pwwn) $ BODILY INJURY(Par KcIdel,O S PROPERTY DAMAGE (Peraccidenn E X X Gar Keep&he E 50, X I $ A X UMMELLA,LIAB EXCEBSLIAB X OCCUR CLAMS -MADE X ECP01W529 04/30/14 OW0115 EACH OCCURRENCE E 1,000, AGGREGATE E 1,000, X DEDUCTIBLE RETENTION S 10000 S S B WORKERS COMPENSATION AND EMPLOYERS' LIABYJTY ANY PROPRIETORIPARTNER,EWCUTIVE YIN EM SER EXCLUDED?(Mandatary M NFQASE-EA describeuncle OF OPERATIONS Wim NIA 155441 05/01M4 0W115 STATLL X OTH- DRYFE S 500,EOFFICERI TEL�04ACCIDENT EMPLOYEE E SD0,00Iryes ASE-POLICY LIMIT S 500,00DESCRIPTION "EC;EiVP DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ASach ACORD 101, AddiMonal Remarks Schedule, Ifmen span Is reRmrod) City of Fort Collins is named as additional insured with respect to the AN O e elORl General Liability, Auto Liability, and Umbrella Liability policies. 6 J L City of Fort Collins Building Department Financial Services Purch Divi PO Box 580 CITY OF 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 (2009f09) 91988-2009 ACORD CORPC The ACORD name and logo are registered marks of ACORD reserved.