The URL can be used to link to this page

Home My WebLink About129729 EXODUS MOVING & STORAGE INC - INSURANCE CERTIFICATE (13)EXODU-1 OP ID: JY ACOROp 70T E (MM/DD/YYYY) `,,� CERTIFICATE OF LIABILITY INSURANCE 8/29/201$ 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 ACT NAME: Kilren E. Siwek, CPA Brown & Brown Inc 4532 Boardwalk Dr, Suite 200 arcNl o Ell: 970-482-7747 aC No): 970-484-4165 Fort Collins, CO 80525 E-MA-ADDRESS: Karen E. Siwek, CPA certificates@bbcolorado.com INSURERS AFFORDING COVERAGE NAIC # INSURER A: Employers Mutual Casualty Co. 21415 INSURED Exodus Moving and Storage Inc INSURER 8: GuideOne Prop & Cas Ins Co 13984 120 NE Frontage Rd Unit D Fort Collins, CO 80524 INSURERC: INSURER D : INSURER E: INSURER F : rr)VFRAr:PA rFRTIGIrATF NI IMRFR• RFVISIAN NIIMRFR- 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 UBR POLICY NUMBER MM DDYPOIUCI MM DDNYYY LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 CLAIMS -MADE OCCUR X 5D73266 09/01/2018 09/01/2019 DAMAGE TO RENTED PREMISES Ea occurrence $ 500,00 MED EXP (Any one person) $ 10,00 PERSONAL & ADV INJURY $ 1,000,00 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,00 POLICY a JE C LOC X 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 5E73266 09/01/2018 09/01/2019 ALL OWNED SCHEDULED AUTOS AUTOS NON -OWNED HIRED AUTOS AUTOS BODILY INJURY (Per accident) $ PROPERTY DAMAGE Peraccident _._ $ $ X Cargo UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 5,000,00 AGGREGATE $ 5,000,00D B LIAB CLAIMS -MADE X 560000655-00 09/01/2018 09/01/2019 nXCESS I X 1 RETENTION $ 0 $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y / N OFFICER/MEMBER EXCLUDED? ❑ (Mandatory in NH) N/A 5H73266 09/01/2018 09/01/2019 X I PER OTH- STATUTE ER E.L. EACH ACCIDENT $ 1,000,00 E.L. DISEASE - EA EMPLOYEEI $ 1,000,00 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 1,000,00( A Cargo I 5C73266 09/01/2013 09/01/2019 Cargo 500,00 A (Warehouse 5C73266 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) City of Fort Collins and its elected & appointed officials & employees are included as additional insureds as their interests may appear on the general liability & auto liability if required by written contract. Waiver of subrogation applies on the workers compensation if required by written contract per form 359b r CDTICIf`ATG ur%l nCD rANrFI I ATIr1N FORTCOL SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of Fort Collins Purchasing P.O. Box 580 AUTHORIZED REPRESENTATIVE Karen E. Siwek, CPA Fort Collins, CO 80522 U 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD EXODUA PAGE 2 NOTEPAD INSURED'S NAME Exodus Moving and Storage Inc OP ID: JY Date 08/29/2018 When required by written contract the following forms may apply: General Liability: Blanket Additional Insured - Form CG7578 Blanket Waiver of Subrogation - Form CG7578 Primary and Non -Contributory - Form CG7578 kutomobile Liability: 31anket Additional Insured - Form CA7450 31anket Waiver of Subrogation - Form CA7450 corkers Compensation: 3lanket Waiver of Subrogation - Form WC 000313 ess Liability: low Form Inland Marine: Carrier: Employers Mutual Casualty Company Policy Number: 5C73266 Term: 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