HomeMy WebLinkAboutTEAMMATES COMMERCIAL INTERIORS - INSURANCE CERTIFICATE0 DATE (MWDD'YYYY)
�. CERTIFICATE OF LIABILITY INSURANCE 1011;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 endorsements).
PRODUCER CONTACT
VaICfIC B'OWn _
Commercial Risk Solutions PHONE 303-996-7847 :303-757 7719
6600 E Hampden Ave Ste 200 E-MAILwn crsd
Denver CO 80224 D vbro?Pnver com
_-
INSUPER(S) AFFORDING COVERAGE _ NAIC It
INSURER A: Westfield Insurance 24112
INSURED TEAMM-1 INSURER B : PlnnaCOl Assurance 41190
Teammates Commercial Interiors --
320 S Teller Street, Suite 250 INSURER C :
Lakewood CO80226-3237 INSURERD:
INSURER E
INSURER F :
rnVFRAr;FS rFRTIFICATF NIIMRFR• 1')1An7gQr7 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,
AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
_EXCLUSIONS
ILTR�i— TYPE OF INSURANCE ADD� POLICY NUMBER POLICY EFF MMDDYYYYn LIMITS
A
X COMMERCIAL GENERAL LIABILITY
Y
CWP3177709
10/1/2018
10,1/2019
EACH OCCURRENCE
$1.000,000
CLAIMS -MADE X I OCCUR
C:__.
I
_DAMAGE TO RENTED
PREMISS aoccurrence
�__(E_-___._
$500,000
MED EXP (Any oneperson)
$ 5,000
PERSONAL & ADV INJURY _
$1,000,000 _._.__
GEN'LAGGREGATELIMITAPPLIESPER:
GENERAL AGGREGATE
$2,000,000
POLICY ! JC PRO -
POLICY JECT LO ;
:_
PRODUCTS • CAMP/OP AGG
$ 2,000,000
OTHER:
$
A
AUTOMOBILE LIABILITY
Y
CWP3177709
10IV2018
10/1/2019
COMBINED SINGLE LIMIT
Es accident
$1,000,000
BODILY INJURY (Per person)
_
$
X ANY AUTO
OWNED SCHEDULED
AUTOS
AUTOS ONLY PX
BODILY INJURY (Per aockient)
$
WA_ _ —
PROPERTY DAMAGE
r accident)
$
XHIRED NON -OWNED
AUTOS ONLY AUTOS ONLY
$
A
X
"^
UMBRELLA LIAB X 'OCCUR
CWP3177709
10/112018
10/1/2019
EACH OCCURRENCE
-- ^
$6,000.00D
EXCESS LIAR CLAIMS -MADE
AGGREGATE
$ 5.000, 000
DIED 1 X RETENTION$ 0
$
B WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY Y 1 N
ANYPROPRIETOR%PARTNERiEXECUTIVE n
( 4062360
10/1/2018
i -
1011/2019
X PTATUTE ERA
E.L. EACH ACCIDENT
$ 1,000,000
O=FICER;MEMBEREXCLUDED'
NIA
—
(Mandatory In NH) I
E.L. DISEASE - EA EMPLOYEE
$1,000,000
E.L. DISEASE - POLICY LIMIT
$ 1.000 000
Fl �•es, describe under
F�SC;RIPTION OF OPERATIONS below
I
DESCRIPTION OF OPERATIONS , LOCATIONS: VEHICLES (ACORD 101. Additional Remarks Schedule, may be attached it more apace is required)
Re: 8026 Furniture for New Utilities Administration Building. The City of Fort Collins, its officers, agents and employees are included as additional insured for
ongoing operations on the General Liability and included as additional insured on the Auto Liability with respect to operations of the named insured for the
certificate holder as required by written contract. All policy terms, conditions and exclusions apply.
rFRTIFICATF H(71i DFR CANCELLATION
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 Financial Services Purchasing Devision
P.O. BOX 580
AUTHORIZED REPRESENTATIVE
Fort Collins CO 80522
(9 198.5-2015 ACOHU GUHFUHA I IUN. Ali rigntS reservea.
ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD