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Home My WebLink About129729 EXODUS MOVING & STORAGE INC - INSURANCE CERTIFICATE (11)EXODU-1 OP ID: JY ACORO' P ATE (MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE TE(MMI DNY 018 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 NAME CT Karen E. Siwek, CPA Brown 8 Brown Inc PHONE 970-482-7747 1C No 970�84-4165 4532 Boardwalk Dr, Suite 200 A/c No El Fort Collins, CO 80525 l Karen E. Siwek, CPA ADDRESS: certificates@bbcolorado.com INSURERS AFFORDING COVERAGE NAIC p INSURER A:Employers Mutual Casualty Co. 21415 INSURED Exodus Moving and Storage Inc INSURER B:GUideOne Prop & Cas Ins Co 13984 120 NE Frontage Rd Unit D Fort Collins, CO 80524 INsuRERc: INSURER D : INSURER E: INSURER F : r_nVFRArFR rFRTIFICATF NI IAARFP- RFV111ARI d MI]MRFRr 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 ADDLTYPE OF INSURANCE INSD B POLICY NUMBER MM LTR /DD/YYY MM/DD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 CLAIMS -MADE � OCCUR X X 5D73266 09/01/2018 09/01/2019 DAMAGE TO RENTED_ PREMISES Ea occurrence $ SOO,OO MED EXP (Any one person) $ 10,00 PERSONAL & ADV INJURY $ 1,000,00 GEML AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,00 X POLICY PRO JECT ❑ LOC PRODUCTS - COMP/OP AGG $ 2,000,00 $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ 1,000,000 BODILY INJURY (Per person) $ A X ANY AUTO X X 5E73266 09/01/2018 09/01/2019 ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ NON -OWNED HIRED AUTOS AUTOS $ X Cargo UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 6,000,00 X AGGREGATE $ 51000,00 B EXCESS LIAB CLAIMS -MADE 560000655-00 09/01/2018 09/01/2019 DED X RETENTION $ 0 $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y f N X 5H73266 09/01/2018 09/01/2019 PER OTH- X STATUTE ER E.L. EACH ACCIDENT $ 1,000,00 OFFICER/MEMBER EXCLUDED? ❑ (Mandatory in NH) N/A E.L. DISEASE - EA EMPLOYEE $ 1,000,00 E.L. DISEASE - POLICY LIMIT 1 $ 1,000,00 If yes, describe under DESCRIPTION OF OPERATIONS below A A Cargo Warehouse SC73266 SC73266 09101/2018I 09/01/2019 Cargo 500,00 09/01/2018 09/01/2019 Warehouse 1,750,00 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Certificate Holder is included as additional insured per policy forms and conditions on page 2. f CDTICi!`ATC LJrll 1711=0 rANrFI I ATIr1Al CITYOFF SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. The City of Fort Collins Purchasing Department PO Box 580 AUTHORIZED REPRESENTATIVE Karen E. Siwek, CPA Fort Collins, CO 80522 CO 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD EXODU-1 NOTEPAD INSURED'S NAME Exodus Moving and Storage Inc OP ID: JY When required by written contract the following forms may apply: eneral Liability: lanket Additional Insured - Form CG7578 lanket Waiver of Subrogation - Form CG7578 rimary and Non -Contributory - Form CG7578 utomobile Liability: lanket Additional Insured - Form CA7450 lanket Waiver of Subrogation - Form CA7450 orkers Compensation: lanket Waiver of Subrogation - Form WC 000313 xcess Liability: ollow Form nland Marine: arrier: Employers Mutual Casualty Company olicy Number: 5C73266 erm: 09/01/2018 to 09/01/2019 for Truck Cargo $1,000,000 - Castatophe Limit $ 500,000 - Property in Vehicles rehouse Legal Liability $1,750,000 - Limit PAGE 2 Date 08/29/2018