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HomeMy WebLinkAboutBENSON ROLL-OFF SERVICES LLC - INSURANCE CERTIFICATEBENSO-1 ACORO CERTIFICATE OF LIABILITY INSURANCE DATE(M1110912018/Y) �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 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 970-482-7747 C NTACT Allison Heeren Brown & Brown Inc PHONE 970-482-7747 FAX 970-484-4165 4532 Boardwalk Dr, Suite 200 A/C, No, Ext►: (A/C, No): Fort Collins, CO 80525 RMSSv certlflcates@bbcolorado.com Tyler McCallister INSURED Benson Roll -Off Services, LLC 6885 Lowell Blvd. Denver, CO 80221 American Automobile Ins Co 121849 Argonaut Insurance Company 19801 r'r1VCOA1_FC CG0T11=1CATF NI IMRGR• RG\/ICIAW KIIIIIARFR• 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 TYPE OF INSURANCE ADDL SUB POLICY NUMBER POLICY EFF POLICY EXPLTR DDIYYYYI LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE " OCCUR MXG80992115 11/07/2018 11/07/2019 EACH OCCURRENCE $ 1,000,000 DAMPREAGE TSESO RENTED 100,000 MED EXP (Any oneperson) 5,000 PERSONAL & ADV INJURY 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: X POLICY ipreT F LOC OTHER: GENERAL AGGREGATE 21000,000 PRODUCTS - COMP/OP AGG 2,000,000 A AUTOMOBILE LIABILITY ANY AUTO OWNED SCHEDULED AUTOS ONLY X AUTOS X AUTOS ONLY X AUTOS ONLY MXG80992115 11/07/2018 11/07/2019 COMBINEDSINGLELIMIT $ 1,000,000 BODILY INJURY Perperson) $ $ _ $ BODILY INJURY Per accident PPe�acGdent AMAGE UMBRELLA LIAR EXCESS LIAB CLAIMS -MADE EACH OCCURRENCE $ HOCCUR AGGREGATE $ DED RETENTION $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ApNFFICERIIMI MBER EXCLUDED? ECUTIVE � N / A (Mandatory in NH) if yes, describe under DESCRIPTION OF OPERATIONS below C92833847297d 12/01/2018 12I01/2019 X PER OTH- STATUTE ER E.L. EACH ACCIDENT 1,000,000 $ E.L. DISEASE - EA EMPLOYE 1,000,000 E.L. DISEASE - POLICY LIMIT 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) l =MO IITUTATC Ur%l r1CD rAK1f CI I ATIr1N CITYFC2 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 PO Box 580 Fort Collins, CO 80522 AUTHORIZED REPRESENTATIVE Tyler McCallister ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD NOTEPAD NSURED'SNAME BENSO-1 OP ID: AH Benson Roll -Off Services, LLC If required in a written contract, the following endorsements apply on a blanket basis: General Liability: CG7193 (01/14) - Includes additional insured, primary and non-contributory provision for additional insureds, automatic waiver of rights of subrogation Auto Liability: CA7018 (10/14) - Includes additional insured and waiver of rights of subrogation CA9948 - Broadened Pollution Coverage Workers Compensation: WC000313 (04/84)- Waiver of Subrogation PAGE 2 Date 11/09/2018