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HomeMy WebLinkAboutWALKER MANUFACTURING CO - INSURANCE CERTIFICATE (4)ACOROF CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 09/23/2018 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 have ADDITIONAL INSURED provisions or 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 CONTACT Kelly Beauvais, CIC, CISR NAME: Flood and Peterson PHONE (970) 266-7121 FAX (970) 330-1867 A/C No Eat): A/C, No PO Box 578 E-MAIL kbeauvais@floodpeterson.com ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # Greeley CO 30632 INSURERA: Twin City Fire Insurance Company 29459 INSURED INSURER B : Sentinel Insurance Company 11000 Walker Manufacturing Co. INSURER C : Pinnacol Assurance 41190 5925 East Harmony Road INSURER D : INSURER E : Fort Collins CO 80528 INSURER F : COVERAGES CERTIFICATE NUMBER: MASTER x 2019 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 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 INSD WVD POLICY NUMBER POLICY EFF MM/DDN POLICY EXP MMIDD/YYYY LIMITS COMMERCIAL GENERAL LIABILITY CLAIMS -MADE ®OCCUR EACH OCCURRENCE $ 1 .000,000 PREMISES Ea occurrence S 300.000 MED EXP (Any one person) $ EXCLUDED SIR$100,000 PERSONAL & ADV INJURY $ 1,000,000 A 34ECSOF1729 09/30/2018 09/30/2019 GEN'LAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY ElPRO-❑ JECT LOC PRODUCTS-COMP/OP AGG 2,000,000 $ S OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT "Ea accident $ 1,000,000 BODILY INJURY (Per person) S ANY AUTO B OWNED SCHEDULED AUTOS ONLY AUTOS 34CPRZT8932 09/30/2018 09/30/2019 BODILY INJURY (Per accident) $ HIRED NON -OWNED AUTOS ONLY AUTOS ONLY PROPERTY DAMAGE Per accident $ Medical payments s 10,000 UMBRELLA LAB OCCUR EACH OCCURRENCE S AGGREGATE S EXCESS LIAB CLAIMS -MADE DED I I RETENTION S $ WORKERS COMPENSATION FER OTH- C AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER,EXECUTIVE ❑ OFFICER/MEMBER EXCLUDED? (Mandatory In NH) NIA 2270632 04701i2018 04lOtl2019 STATUTE ER E.L. EACH ACCIDENT 500,000 S E.L. DISEASE - EA EMPLOYEE S 500.000 If yes, describe under DESCRi?TiON OF OFERATIONS below E.L. DISEASE - POLICY LIMIT 500,000 $ DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101. Additional Remarks Schedule, may be attached if more space is required) Certificate Holder is Additional Insured as their interests may appear regarding land leased at: RECEIVED SEP 2 8 2018 City Manager's C)ff,. ,: CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City Manager; City of Ft. Collins ACCORDANCE WITH THE POLICY PROVISIONS. 300 LaPorte Ave AUTHORIZED REPRESENTATIVE Fort Collins CO 80521 `+ 0 © 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD