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HomeMy WebLinkAbout168310 SCHRADER OIL CO - INSURANCE CERTIFICATE (7)SCHRA-1 OP ID: GRTI , `4 o- CERTIFICATE OF LIABILITY INSURANCE ��- DATE12912014 09129/2014 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 Legacy Insurance Network 3455 Briargate Blvd Ste 215 Colorado Springs, 30 80920 Tim Gries NAMEpCT Tim Gries PHONE 719-593-5614 (WC No:719-388-2075 A/C No Eat: SS: tim@legacyinsurancebroker.com ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC# INSURER A: United States Fire Ins. CO. 21113 INSURED Schrader Oil Cc Schrader Properties INSURER B: Pinnacol 41190 Schrader Land Cc INSURER C RS& S LLP, SCHRADER PROPANE 320 N College INSURER D: Ft Collins, CO 80524 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 NTH 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 POLICY NUMBER MM/DDrfYYY) (MMIDDIYYYYl LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE FxIOCCUR 506-877095.7 0613012014 06130/2015 EACH OCCURRENCE $ 1,000,000 PREMISES Eaoccarrence $ 100,00 MEDEXP(Any one person) $ 5,00 PERSONAL S ADV INJURY $ 1,000,00 GENERAL AGGREGATE $ 2,000,00 GEN'L AGGREGATE LIMIT APPLIES PER. X POLICY PRO LOU JECT PRODUCTS - COMPIOP AGG $ 1,000,00 $ A AUTOMOBILE LIABILITY ANY AUTO X ALL OWNED SCHEDULED AUTOS AUTOS X X NON -OWNED HIRED AUTOS AUTOS 506-877095-7 0613012014 06130/2015 NE I COMB D SINGLE LIMIT Ea E $ 1,000,00 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE PER ACCIDENT $ 8 A X UMBRELLA LIAB EXCESS LIAR X OCCUR CLAIMS -MADE 523-800168-3 0613012014 06/3012015 EACH OCCURRENCE $ 4,000,000 AGGREGATE $ 4,000,00 DED I X I RETENTION$ 0 $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETORIPARTNERIFJ(ECUTIVE YIN OFFICERIMEMBER EXCLUDED' (Mandatory In NH) f yesticribe under , es OE SCRIPTION OF OPERATIONS below NIA 4061859 10/0112014 10/0112015 X WCSTATU- TH- TORY LIMITS ER EL EACH ACCIDENT $ 1,000,000 E.L. DISEASE $ 1r000,000 LEEMPLOYE E.L. DISEASE - POLIC YLIMIT $ 1,000,00 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, AddRlonal Remarks, Schedule, if more apace Is required) 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 Tim Gries ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD