HomeMy WebLinkAboutSHEET METAL PRODUCTS INC - INSURANCE CERTIFICATE (2)Client#: 1246901
SHEETMET23
ACORD,. CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/VYVY)
313112015
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
USIInsurance Service
1904 Warren Avenue
Cheyenne WY 82001
CON
NAME: Vale
PHONE 3
AIC No Eatil: 635 4231
E-MAIL lerie.robatCh
ADDRESS: vaY
_
INSURED
Sheet Metal Products, Inc
PO Box 1112
Cheyenne, WY 82003
AFFORDING COVERAGE
lity Insurance Co
COVERAGES CERTIFICATE NUMBER: RFVISInN NIIMRFR-
635-4237
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 CONTRACTOR 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
ADDLSUBIR
INSR
WVD
POLICY NUMBER
POLICY EFF
MMIDDNYYY)
POLICY EXP
(MM1DDNYYYj
LIMITS
A
GENERAL LIABILITY
COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE a OCCUR
CBP8631329
4/01/2015
04/01/2016
EACH OCCURRENCE
1
$000000
MCH�OE
D
PREMqISES a csTurrence
$100 000
MED EXP (Any one person)
$$ 000
PERSONAL S ADV INJURY
GENERAL AGGREGATE
GEN'L AGGREGATE LIMIT APPLIES PER:
POLICY PRO-LOC
PRODUCTS-COMP/OP AGG
Rs2000,000
A
AUTOMOBILE
LIABILITY
ANY AUTO
AU OS SCHEDULED
AUTOS AUTOS
HIRED AUTOS �( NON -OWNED
AUTOS
BA8630529
4/01/2015
04/01/2016
EaaccidentSINGLELIMIT
BODILY INJURY (Per person)
BODILY INJURY Pereccident
i )
)t
PROPERTY DAMAGE
Per accident
$
$
A
UMBRELLA LIAR
EXCESS LIAR
OCCUR
CLAIMS -MADE
CUB631929
01/2015
04/01/2016
EACH OCCURRENCE
$2 000 000
AGGREGATE
s2 000 OOO
DED RETENTION$
$
A
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITYJMIjS
ANY PROPRIETOR/PARTNER/EXECUTIVE YIN
OFFICER/MEMBER EXCLUDED? a
(Mandatory in NH)
If yes, describe under
DESCRIPTION OF OPERATIONS below
MIA
CBP8631329
D4101/2015
04/01/201
we YTATLI oTH-
E.L. EACH ACCIDENT
$
E.L. DISEASE- EA EMPLOYEE
$
E.L. DISEASE - POLICY LIMIT I
s
A
Wyoming Stop Gap
CBP8631329
L W011/20115
ON011201
1,000,000
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required)
Certificate issued usual to contracting operations on current insurance policy of Sheet Metal Products,
Inc.
This Certificate is issued as respects to the business operations of the insured.
City of Fort Collins
PO BOX 580
Fort Collins, CO 80522-0000
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
ACORD 25 (2010105) 1 Of 1
#S14771184IM14757963
\C
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