HomeMy WebLinkAbout165007 ACTION SIGNS - INSURANCE CERTIFICATEDATE (MMIDDNYYY)
ACCORD® CERTIFICATE OF LIABILITY INSURANCE
lla.� 1 10/16/2018
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 NAME- AN Duroux
Mountain Plains Agency, Inc.
4532 McMurry Ave., Suite 101
Fort Collins, CO 80525
AFFORDING
.com
INSURED
INSURER B :
Action Signs &Banners, LLC
CHARLES LERICH
INSURERC:
PO Box 270096
INSURER D :
Fort Collins, CO 80527-0096
INSURER E.
INSURER F :
CnVFRAC;FS CFRTIFICATF NIIMRFR•
nnnnnnM--mmaa 0FVICIl1N NIIIUII C
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.
TR
TYPE OF INSURANCE
INSD
WVD
POLICY NUMBER
MM/DDffYY
POLICY EXP
LIMITS
A
X
COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE � OCCUR
Y
ACPGLA03046842705
10/06/2018
10/06/2019
EACH OCCURRENCE
$ 1,000,000
DAMAGE TO RENTED
PREMISES (Ea occurrence)
$ 100,000
MED EXP (Any one person)
$ 5,000
GEN'L
X
PERSONAL & ADV INJURY
$ 1,000,000
AGGREGATE LIMIT APPLIES PER:
POLICY ❑ PRO-
JECT LOC
OTHER
GENERAL AGGREGATE
$ 2,000.000
PRODUCTS - COMP/OP AGG
$ 2,000,000
$
A
AUTOMOBILE
JXANY
LIABILITY
AUTO
OWNED SCHEDULED
AUTOS ONLY X AUTOS
HIRED NON -OWNED
AUTOS ONLY X AUTOS ONLY
ACPBAPD3046842705
10/06/2018
10l06/2019
COMBINED SINGLE LIMIT
$ 1. 00,000
BODILY INJURY (Per person)
$
BODILY INJURY (Per accident)
$
PROPERTY DAMAGE
Per accident
$
A
X
UMBRELLA LIAB
EXCESS LIAB
X
OCCUR
CLAIMS -MADE
ACPCAA3046842705
10/0612018
10/06/2019
EACH OCCURRENCE
$
AGGREGATE
$
DED RETENTION $
$
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY YIN
ANY PROPRIETORIPARTNER/EXECUTIVE
OFFICER/MEMBER EXCLUDED? ❑
(Mandatory in NH)
If yes, describe under
DESCRIPTION OF OPERATIONS below
NIA
PER OTH-
STATUTE ER
E.L. EACH ACCIDENT
$
E.L. DISEASE - EA EMPLOYE
$
E.L. DISEASE - POLICY LIMIT
$
DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
City of Fort Collins
281 N. College Ave.
Fort Collins, CO 80524
CANCELLATION
SHOULD ANY OF.THE ABOVE.DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF. NOTICE WILL BE DELIVERED IN
-19118-201 AGOR ORPORATION. All ri§hts reserved.
ACORD 25 (2016/03) The ACORD name and logo are registered marks of WORD
nted by AJD on October 16, 2018 at 11:26AM