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HomeMy WebLinkAbout104002 COLORADO IRON AND METAL - INSURANCE CERTIFICATE (3)COIRO-1 OP ID: JD ,a►�o�zo CERTIFICATE OF LIABILITY INSURANCE DAT09109D/YYYY) oslos/1a 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 Phone: 970-482-7747 Brown g Brown Inc 4532 Boardwalk Dr, Suite 200 Fax: 970-484-0165 Fort Collins, CO 80525 Tyler B. Allen CONTACT NAME: NE FAX (A/c No, E.t): AIC, No: — E-MAIL ADDRESS: INSURERS) AFFORDING COVERAGE NAM k INSURER A:WestfiieldInsurance Company 24112 INSURED Colorado Iron and Metal, Inc. 903 Buckingham INSURER e: Plnnacol Assurance Company 41190 Ft Collins, CO 80524 INSURER C INSURER D INSURER E INSURER F COVERAGES CERTIFICATE NUMBER: RFVISInN NHMRFR- 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 ADDL3UBR IINSR MO POLICY NUMBER POLICY EFF MMIDDIYYYYI POLICY EXP I(MM1DDNYYY1 LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR TRA1824364 09101114 09101115 PREMISES Ea occurrence $ 500,000 MED E%P(My one person) $ 5,000 PERSONAL S ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: Poucv n JFQT PRO- LOC PRODUCTS - COMPIOP AGO $ 2,000,00 Emp Ben. $ 1,000,000 AUTOMOBILE LIABILITY ECOMBINED tSINGLE LIMIT ) 11$ 1,000,000 X BODILY INJURY (Par person) $ A ANY AUTO TRA1824364 09101/14 09/01115 ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident)$ NON -OWNED HIRED AUTOS AUTOS PROPERTY DAMAGE Per accident $ $ X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 2,000,000 AGGREGATE $ 2,000,000 A EXLESSLIAB CLAIMS -MADE TRA1824364 09/01114 09/01/15 CEO X RETENTION$ 0 $ WORKERS COMPENSATION WC STATU- OTH- B AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNON ECUTIVE YIN OFFICERRdEMBER E%CWDED? ❑ MIA 3333756 06101/14 06101115 TORY LIMITS R EEACH L ACCIDENT $ 500,000 E.LDISEASE-EAEMFI- $ SOO,OO (Myaendatonr In NH) E.L. DISEASE -POLICY LIMIT $ 500,00 DESCRIPTION OF OPERATIONS belay A Commercial Applica TRA1824364 09101/14 09101115 A DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, K more space Is required) Fax: 530-0301 City of Fort Collins Natural Resources Department 281 N College Avenue Fort Collins, CO 80522 FTCNATR SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORRED REPRESENTATIVE p� ��U'- ` ACORD 25 (2010105) ©1 The ACORD name and logo are registered marks of ACORD TION. All rights raservad. COIRCIA PAGE 2 NOTEPAD INSUREDS NAME Colorado Iron and Metal, Inc. OP ID: JD DATE 09/09/14 If required by written contract, the following endorsements apply on a blanket basis: General Liability: CG2010 (04/13)- Additional Insured- Owners, Lessees or Contractors CC2037 (04/13) - Additional Insured - Owners, Lessees or Contractors -Completed Operations CG7055 (01/13) Other Insurance Condtion Amended (Primary & Non -Contributory) Auto Liability: CA7077 (09/11) -Business Auto Signature Series Endorsement, includes Additional Insured. CA0444 - Waiver of Transfer of Rights of Recovery Workers Compensation: 359-B-Blanket Waiver of Subrogation Umbrella: Following Form