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HomeMy WebLinkAbout340571 MAX FIRE APPARATUS INC - INSURANCE CERTIFICATE (7)MAXFI-1 OP ID: SEA ,�►coizo CERTIFICATE OF LIABILITY INSURANCE lih� DATE(M"DNYYY) 1 12/01/2014 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 CRS Insurance Brokerage Commercial Risk Solutions DBAINC.Na NAME CTSherry A. McGann PHONE FMM Eae:303-996-7801 ac Na: 303-757-7719 E-MAIL ADDRESS: 6600 E. Hampden Ave. Denver, CO 80224 Sherry A. McGann INSURERISI AFFORDING COVERAGE NAIC d INSURER A: Hartford Insurance Company 22357 INSURED Max Fire Apparatus, Inc. INSURER 8: Pinnacol Assurance Michaels Bacon P.O. Box 1658 INSURER C: Castle Rock, CO 80104 INSURER D: INSURER E NSURERF: 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. ILTR NSR TYPE OF INSURANCE POLICY NUMBER MMIDDrIYI MMIDDIYYXYY LIMITS A X COMMERCIALGENERALLIABILITY CLAIMS -MADE [X ] OCCUR X 34UUNQ08093 11/01/2014 11/01/2015 EACH OCCURRENCE S 1,000,00 PREMISES IE. ouvnence $ 300,00 MED EXP(Any one penan) f 10,00 PERSONAL B ADV INJURY $ 1,000,00 GEN'L AGGREGATE LIMIT APPLIES PER: X POLICY PO - JET M LOC OTHER: GENERAL AGGREGATE $ 2,000,00 PRODUCTS - COMPIOP AGG $ 2,000,00 $ A AUTOMOBILE LIABILRY ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS X NI;OI MED HIRED AUTOS AUTOS 34UUNQ08093 11/01/2014 11/01/2015 COMBINED SINGLE LIMIT Ea..dart f 1,000,00 X BODILY INJURY (Par person) $ BODILY INJURY (Per soadws) $ X PROPERTY DAMAGE Peraccidan1 f f A X UMBRELLALNB EXCESS LIAa X OCCUR CLUMS�MADE 34HH0008094 11/01/2014 11/01/2015 EACH OCCURRENCE 3 1,000,00 AGGREGATE f 1,000,00 DEO I X I RETENTIONf 10,000 S A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETORIPARTNERIEXECUTNE YIN OFFICERIMEMBER EXCLUDED? Y� (Mdatory in NH) yan DEI, RIPTIObN OF OPERATIONS below NIA 34WEQ08913 11/30/2014 11/30/2015 X PER OTH- STATUTE ER E.L. EACH ACCIDENT Is 1,000,00 E.L. DISEASE - EA EMPLOYEE f 1,000,00 E.L. DISEASE -POLICY LIMIT $ 1,000,00 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, AddMdnal Ramada; Schoduls, may M attached N more space is mqulrsd) Re: Fleet Maintenance. City of Fort Collins is included as additional insured on the General Liability with respect to ongoing operations of the named insured for the certificate holder as required by written contract. 1 policy terms, conditions and exclusions apply. CIFORTC 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. AUTHOWED REPRESENTATIVE EP ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD