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HomeMy WebLinkAboutFERRIE FRANZMANN INDUSTRIES LLC - INSURANCE CERTIFICATE (2)A� & CERTIFICATE OF LIABILITY INSURANCE
ATE
D10/03/2014Y)
10/03/2019
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 1-303-534-4567
IMA, Inc. - Colorado Division
CONTACT
NAME:
PHONE FAX
(AIC No Fail Alt No:
E-MAIL denpant@imatcorp.com
ADDRESS: P P•com
1705 17 th Street
INSURERS AFFORDING COVERAGE
NAICN
Suite 100
INSURER A: LIBERTY MUT FIRE INS CO (LIBERTY MUTUAL
11748
Denver, CO 80202
INSURED
INSURER B: GREAT NORTHERN INS CO (Chubb)
20303
Ferris Franzmann Industries, LLC
ESE Matron Packaged Pump Systems, LLC
INSURER c: FEDERAL INS CO (Chubb)
20281
1505 N Third Ave
INSURER D:
INSURER E:
INSURER F:
Denver, CO 80223
COVERAGES CERTIFICATE NUMBER: 41752888 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
rypE OF INSURANCE
ADDL
SUBR
POLICY NUMBER
POLICY EFF
MM/DDIYYYY
POLICY EXP
MMIDDIYYYY
LIMITS
A
GENERAL LIABILITY
TB2Z91452868054
10/01/14
10/01/15
EACH OCCURRENCE
$ 1,000,000
� OCCUR
�fCBOJMMERCIAL
DAMACLAIMS-MADE
PREMI ES I RENTED300,000
PREMISES Ea urrence
$/PD
MED EXP(Any one person)
$ 10,000
Ded: $10,000
PERSONAL S ADV INJURY
$ 1,000,000
GENT AGGREGATE LIMIT APPLIES PER:
GENERAL AGGREGATE
$ 2,000,000
POLICY jRo- [X] LOC
PRODUCTS - COMPIOP AGO
$ 2,000,000
$
OTHER:
B
AUTOMOBILE
LIABILITY
73571965
10/01/14
10/01/15
COMBINED SINGLE LIMIT
Ea accident)
$ 1,000,000
X
BODILY INJURY (Per person)
$
ANYAUTO
ALL OWNED SCHEDULED
AUTOS AUTOS
I
BODILY INJURY (Per accident)
$
%
PROPERTY DAMAGE
Per accident
$
NON -OWNED
HIRED AUTOS X AUTOS
UMBRELLA LIAB
OCCUR
EACH OCCURRENCE
$
AGGREGATE
$
EXCESS LIAB
CWMS-MAGE
DED RETENTION$
$
C
C
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY Y I N
ANY PROPRIETORIPARTNEWEXECUTIVE F
OFFICERIMEMBER EXCLUDED')
NIA
71739807
10/01/14
10/01/15
PER
% STATUTE OT-
E.L. EACH ACCIDENT
$ 1,000,000
E.L. DISEASE -EA EMPLOYE
$ 1:000,000
(Mandatory in NH)
If yes, describe under
DESCRIPTION OF OPERATIONS below
E.L. DISEASE -POLICY LIMIT
$ 1, 000, 000
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more apace is required)
The City of Fort Collins, its officers, agents and employees are included as Additional Insureds on the General and
Automobile Liability Policies if required by written contract or agreement subject to the policy terms and conditions.
: RFP 7294 Irrigation Pump Station Maintenance 6 Repair.
ty of Fort Collins
rector of Purchasing and Risk Management
PO Box 580
Collins, CO 80522
USA
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
©1988.2014 ACORD CORPORATION. All rights reserved.
ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD
emeando
41752888