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HomeMy WebLinkAbout458840 C & S SPECIALTY SYSTEMS INC - INSURANCE CERTIFICATE (9)4COJR0® CERTIFICATE OF LIABILITY INSURANCE �� ­DATEDD- 6/27/2014 •- 27/ 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). - - PRODUCER-l' - Colorado-BW Insurance Agency, Inc. 12000 North Washington -.-._.__. CONTACT Johna Moors ' NAME: PNCNE (303)451-5547 1 FAAX,Nc,(303)451-0605 E-MAIL .johna.moors@bankofthewest. com Suite' 300 .:_. ,. _ .� �. Thornton CO 80241 _.. INSURERS AFFORDING COVERAGE - NAICq INSURER A:Scottsdale Ins CO ' INSURED .. - - - INSURER 9:State Auto Insurance Companies INSURERC:Pinnacol Assurance 41190 C 6 S Specialty Systems Inc INSURER O: 5609 W 6th Ave., Unit B INSURER E INSURER F: Lakewood CO 80214 COVERAGES CERTIFICATE NUMBER:14-15 SA rnwl 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 SUBR POUCYNUMBER POUCY EFF MMI pnYYY) POLICY EXP (MMIDDfYYYY1 LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 PREMISES Ea occurrence $ 100,000 A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE ❑X OCCUR CPS1948667 /8/2014 /8/2015 MED EXP (Ar, we person) $ 5,000 PERSONAL B ADV INJURY $ 1,000,000 X Professional Liability $1,000,000 GENERAL AGGREGATE $ 2,000,000 GENT AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMPIOP AGG $ Include X POLICY X PRO- LOC - $ AUTOMOBILE LIABILITY ,: COMBINED t SINGLE LIMIT11000,000 X BODILY INJURY (Per pemm)' B ANY AUTO' - ALL OWNED SCHEDULED AUTOS AUTOS BAP222069306 ' ' /1/2014' _ /1/2015 BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accidem $ NON -OWNED HIRED 'AUTOS .. AUTOS ` Uninsured motorist BI s Id limit $ 1 000 000 DO X UMBRELLA UAB X OCCUR EACH OCCURRENCE S 4,000 000 AGGREGATE S 4,000,000 A EXCESS LIAB CLAIMS -MADE , DED I I RETENTION$ 10,00C $ PCBS0036939 /8/2014 /8/2015 C WORKERS COMPENSATION ANDEMPLOYERS'UABIUTY YIN ANY PROPRIETORIPARTNER/EXECUTIVE OFFICERNEMBER EXCLUDED? (Mandatory in NH) NIA 143792 /1/2014 /1/2015 X W'C STATU- OTH- LIMITS E.L. EACH ACCIDENT S 1 0OO 000 E.L. DISEASE - EA EMPLOYE S 1 000 000 Ifyes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT $ 1 1,000,00 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES IAeach ACORD 101, Additional Remarks Schedule, If more space Is required) City of Fort Collins P.O. 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 AGUKU 25 (2U10I05) INS025 (201005).01 Johns Moors/EVEJM © 1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD