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HomeMy WebLinkAboutCUSTOM DISPOSAL LLC - INSURANCE CERTIFICATE04/14/2015 TUE 9:01 FAX 2001/001 CUSTO-1 OP ID: MB ACORN' CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYY) lllh� 1 04/1412015 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 CONTACT Renaissance Insurance Group PHONE Jay W. Helier P 0 Box 478 ;—FAx 970-674-8825 _. L! Nod..970-674-8826 101 G..Np,Extl__. . E Main Street Windsor, CO 80550 a DRESS: iheizer@reninsurance.com Windsor. -- -- ----- INSURED Custom Disposal, LLC 620 East 3rd Street Eaton, CO 80615 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_. INSR - - _ DOL SUB T__....,,,....._..._..._..........,___ POLICY EFF POLICY EXP ...-"_........_ ___...__.__. LTR TYPE OF INSURANCE Wv POLICY NUMBER MMIDDNYYY MMID➢NYYY DM11SI A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE U OCCUR L57964 0312612015 03/26/2016 EACH OCCURRENCE $ 1,000,00 'DAIEY PR MI�GESD l,LEaoccurrencel S 250,00 MED EXP (Any one person) $ 10,00 GEN'L X AGGREGATE LIMIT APPLIES PER: R. POLICY L JECT _J LOC OTHER: PERSONAL SADVINJURY S 1,000,00( GENERAL_ AGGREGATE $ 3,000,00 PRODUCTS •COMP/OPAGO S 3,000,00 S A AUTOMOBILE .__._ X _ LIABILITY ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS HIRED AUTOS NON.OVVNEO AUTOS L57964 03126/2016 03/26/2016 COMBINED SINGLE LIMIT Ea accident $ 1 000 00 + , BODILY INJURY (Per person) S BODILY INJURY (Per acddanl) S PROPEY DAMA RTGE lawaccidentL,_ S $ UMBRELLA LIAR EXCESS LAB OCCUR CLAIMS -MADE NIA EACH OCCURRENCE S AGGREGATE $ DELI RETENTION$ $ I WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETCRfPARTNERIEXECUTIVE YIN OFFICERIMEMBER EXCLUDED' (Mandatory in NH) If yes, describe under DESCRIPTION UG OPERATIONS below NIA N/A H- STATUTE ER „_ _ E.L. EACH ACCIDENT S - - E.L. DISEASE • EA EMPLOYE ---' S E.L. DISEASE _ POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space Is required) Fax: 970-221-67821Attn: Linda Samuelson CITY OF City of Fort Collins 215 N Mason St 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 REPRESENTAnTIVE © 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (201A101) The ACORD name and logo are registered marks of ACORD