HomeMy WebLinkAboutNATIONAL INSPECTION SERVICES - INSURANCE CERTIFICATEACORD, CERTIFICATE OF LIABILITY INSURANCE
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04/16/ZO14)
04/16/2014
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: N the certificate holder is an ADDITIONAL INSURED, the policy(iss) 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
Ewing -Leavitt Insurance Agency
4025 St. Cloud Dr.
Suite 100
Loveland, CO 8OS39
COIWTACT
NAIVE: CL Central
PHON,E,a,970.679.7333 Ne•866.456.4265
RODIL
REss:
INSURER(S) AFFORDING COVIVACE
BANCO
INSURERA: Pinnacol Assurance
41190
iNsun ,Wil ism J Warren 8 Son LLC
BSA: National Ins ctioo Services
- 1136 tMart Street
Suite 4204
Fort Collins, CO 80525
INSURER Landmark American Ins Co
33138
INSURERC:
INSURER D:
INSURER E:
INSURERF:
COVERAGES CERTIFICATE NUMBER: 13/14 WC 14/15 Prof Liab 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 POUCIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
LTR
TYPE OF NSURANCE
1 R
WVD
POLJCY NUMBER
Ym
MMIDPOLICY EKP
LWRS
GENERAL LIABILITY
COMMERCIAL GENERAL UABILDY
CINMSMADE OCCUR
EACH OCCURRENCE
$
PREMISES Ee =..
S
MED EXP(Any pre Parean)
$
PERSONALaADV INJURY
S
GENERALAGGREiATE
S
GEN'L AGGREGATE UMITAPPLJES PER:
POUCYF_J JE LOC
PRODUCTS-COMPtOPAGG
S
$
AUTOMOBILE LY1BlJTY
ANY AUTO
ALL OWNED SCHEDULED
AUTOS AUTOS
D
HIRED AUTOS AUTOS
W.R. Silfam-nmrr—
ED amMNr
S
BODILY NJURY (Per yawn)
S
BODILY INJURY TW aaMaM)
S
Px
$
S
UMBRELLA LAB
EXCESS LAB
OCCUR
CLAIMS -MADE
EACH OCCURRENCE
5
AGGREGATE
5
DED I I RETENTIONS
5
A
WORxERS Co NSAT1DN
AND EMPLOYERS' LIABILITY
MYPRROFFICERR¢MBE�R/PEXRCLNERI ECUTIV��
(Nyyeeenaadmm MW j—J
DEBCRIPP71ON OF OPERATIONS Iebw
N/A
41S705
07/01/2013
07/01/2014
X
TORY UMRS ER
E.I. EACH ACCIDENT
$ 500,00
E.L DISEASE - EA EMPLOYE
$ 5OD,DV
E.L. DISEASE - POLICY LIMB
1 $ 500,000
B
nvTronmenta
rofessional Liability
LHR823S6
04/22/2014
04112I2015
Per claim limit: $1.000,000
Deductible: $2,500
DESCWPnONOFGPERATq ILOCATNINSIVEIIIeIFA plWolr wCORO1r1, AdamorW Remvrta Selesula Nmon apsesrregWrea)
umm I HrIVA It nVLYCrt --
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 AUTHORIZED REPRESENTATIVE
P.O. Box 580
Fort Collins, CO 80522 Amv zcRackham/AMIU
ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD