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HomeMy WebLinkAboutS & S SANITATION INC - INSURANCE CERTIFICATE (2)OP ID: KH ACORO• CERTIFICATE OF LIABILITY INSURANCE O06/27/201ATE YY) 06/27/2014 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(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 PFS Insurance Group - DV 7200 S Alton Way, Ste A-140 Centennial, CO 80112 Jim Olafson CONTACT NAME: PHONE FAX _(NUyNo Eae : uc NP : EMAIL ADDRESS: PRODUCER CUSTOMER ID #: SSSAN-1 INSURERS AFFORDING COVERAGE NAIC Is INSURED S & S Sanitation, Inc. INSURER A: United Fire & Casualty 13021 559 S. St. Louis INSURERB:Pinnacol Assurance 41190 Loveland, CO 80539 INSURER C INSURER D : 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 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 OF INSURANCE ADDTYPE IMRR POLICY NUMBER MM/DD YYYYPOLICYEFF MMIDD POLICYEXP IYYYYI LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS-01ADE a OCCUR 60033560 09/11/2013 09/11/2014 EACH OCCURRENCE $ 1,000,00 DAMAGETO RE D PREMISES Ea occurrence $ 100,00 MED EXP (Any one person) $ 5,00 PERSONAL$ ADV INJURY $ 1,000,00 GENERAL AGGREGATE $ 2,000,00 GEN'L AGGREGATE LIMIT APPLIES PER POLICY PRO- LOC PRODUCTS - COMP/OP AGG $ 2,000,00 $ A AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS 60033560 09/11/2013 09/11/2014 COMBINED SINGLE LIMIT Ea accident) $ 1,000,00 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ X PROPERTY DAMAGE (PER ACCIDENT) $ X X $ p UMBRELLA LAB EXCESS LAB X OCCUR CLAIMS -MADE 60033560 09111I2013 09111/2014 EACH OCCURRENCE $ 1,000,00 AGGREGATE $ 1,000,00 DEDUCTIBLE RETENTION $ 10,000 $ X $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETORIPARTNERIE%ECUTNE YIN OFFICERIMEMBER E%CLUDED9 (Mandatory in Ni If yes, describe under DESCRIPTION OF OPERATIONS below N I A I 2160642 I 07/01/2014 07/01/2015 I I X T RSTATT- X OTH- EL. EACHACCIDENT $ 600,00 E L. DISEASE - EA EMPLOYEE S 500,00 E. L. DISEASE -POLICY LIMIT 1 $ 500,00 N/A DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (Amon ACORD 101, Additional Ramares Schedule, if more space Is required) All Operations - All Locations CITYOFF City of Fort Collins Treasury Division PO Box 580/281 N College Ave Ft Collins, CO 80522-0580 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 © 1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009/09) The ACORD name and logo are registered marks of ACORD