HomeMy WebLinkAboutWALKER MANUFACTURING - INSURANCE CERTIFICATE (3)lth R CERTIFICATE OF LIABILITY INSURANCE
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DATE/25/ 0[15 V)
3/25/2015
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
Flood and Peterson
PO Box 578
Greeley CO 80632
CONTACT Kelly Beauvais, CIC, CISR
NAME:
PHONENo F,tl. (970) 266-7121 FAX
No): (970)106-6845
E-MAILADDRZSS.kbeauvais@floodpeterson.com
INSURERS AFFORDING COVERAGE
NAIC a
INSURERA:Hrf - The Hartford Insurance
INSURED
Walker Manufacturing Co.
5925 East Harmony Road
Fort Collins CO 80528
INSURERB:Plnnacol Assurance
41190
INSURER C:
INSURER D:
INSURER E :
INSURER F:
COVERAGES CERTIFICATE NUMBER:CL1532501406 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
TYPE OF INSURANCE
ADDL
INSR
SUER
WVQ
POLICY NUMBER
POLICY EFF
MM/DD/YYYV
POLICY EXP
MM/DD/VYYY
LIMITS
GENERAL LIABILITY
EACH OCCURRENCE
$ 1,000,000
A
X COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE FX1 OCCUR
34ECSOF1729
9/30/2014
9/30/2015
DAMAGE TRENTEDPREMI ES Ea occurrence
$ 300, 000
NED EXP(Any one person)
$
PERSONAL &ADV INJURY
$ 1,000,000
GENERAL AGGREGATE
$ 2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
PRODUCTS - COMP/OP AGG
$ 2,000, 000
X POLICY PRO- LOC
$
AUTOMOBILE
LIABILITY
COMBINED SINGLE LIMIT
Ea accident)
1,000,000
X
BODILY INJURY (Per person)
$
A
ANY AUTO
ALL OWNED SCHEDULED
AUTOS AUTOS
4UUNNJ0856
9/30/2014
9/30/2015
BODILY INJURY (Per accident)
S
x
PROPERTY DAMAGE
(Per accident)$
NON -OWNED
HIRED AUTOS x AUTOS
Uninsured motorist combined
S 1,000,000
UMBRELLA LIAB
OCCUR
EACH OCCURRENCE
S
AGGREGATE
$
EXCESS LIAB
CLAIMS -MADE
DED I I RETENTION
$
B
WORKERS COMPENSATION
WC STATI OTH-
AND EMPLOYERS' LIABILITY Y / NDRY
ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICER/MEMBER EXCLUDED? Li
(Mandatory in NH)
N/A
270632
/1/2015
/1/2016
E.L. EACH ACCIDENT
$ 500,000
E. L. DISEASE -EA EMPLOYE
$ 500,000
If yes, describe under
DESCRIPTION OF OPERATIONS below
E.L. DISEASE -POLICY LIMIT
$ 500,000
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required)
Certificate Holder is Additional Insured as their interests may appear regarding land leased at:
City Manager; City of Ft. Collins
300 LaPorte Ave
Fort Collins, CO 80521
L;ANGtLLA I IUN
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
K Beauvais, CIC, CISR 'y;�
ACORD 25 (2010105) 01988-2010 ACORD CORPORATION. All rights reserved.
INS025(201005).01 The ACORD name and logo are registered marks of ACORD