Loading...
HomeMy WebLinkAbout453112 DIVERSIFIED BODY & PAINT SHOP - INSURANCE CERTIFICATEPolicy Number. Date Entered: 1/23/2019 ACOR6r 1%�CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 9/13/2017 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 P and G Insurance Professionals, LLC PO Box 22867 Denver, CO 80222 CONTACT NAME: A/CNNo Ext : (303) 478-4582 plc No): (888) 791-4038 E-MAIL SS: shawn.gerdes@pandgip.com INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: Auto —Owners Insurance 18988 INSURED Diversified Body and Paint Shop, In INSURER B INSURERC: Steve Wolfe INSURER D: 4909 FOX St Denver, CO 80216 INSURER E INSURER F COVERAGES CFRTIFICATF NIIMRFR' DFVISInNI NII IIURGD- 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. IXP LTR TYPE OF INSURANCE ADOL SUER POLICY NUMBER EFF MM DD/YYYV MMIDD/YPOLICY POLICY EYYY LIMITS p. X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE IX OCCUR X 51-039790-00 /1/2019 2/2/2020 EACH OCCURRENCE $ 1, 000 , 000 DAMAGE TO RENTED PREMISES Ea occurrence $ MED EXP (Any one person) $ 5 , 000 PERSONAL & ADV INJURY $ 1 , 000 , 000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY JECT LOC GENERAL AGGREGATE $ 3 , 000 , 000 PRODUCTS - COMP/OP AGG S3,000,000 $ OTHER: A AUTOMOBILE LIABILITY ANY AUTO X 51-039790-00 /1/2019 2/1/2020 COMBINED SINGLE LIMIT Ea accident $ 1 , 000 , 000 BODILY INJURY (Per person) $ OWNED NLY AUTOS SCHEDULED AUTOS O BODILY INJURY (Per accident) $ HIRED NON -OWNED AUTOS ONLY AUTOS ONLY PROPERTY DAMAGE Per accident $ A UMBRELLA LIAB OCCUR EACH OCCURRENCE $ 2 , 000 , 000 AGGREGATE $2,000,000 EXCESS LIAB CLAIMS -MADE 51-039790-00 /1/2019 2/1/2020 DED I I RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED9 ❑ N / A I PER OTH- _ STATUTE ER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ (Mandatory in NH) If yes, describe under E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS below A Garagekeepers,On hook 51-039790-00 2/01/2019 02/01/2020 comp and coil 2,000,000 A Garage Liability 51-039790-00 2/01/2019 02/01/2020 1,000,000 A Business assets 51-039790-00 2/01/2019 02/01/2020 1,500,000 ded 2,500 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Cert holder is additional insured for general and auto liabilty. CERTIFICATE HOLDER CANCELLATION City of Fort Collins PO Box 580 Fort Collins, CO 80522 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE S 64W r ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD Produced using Forms Boss Plus software. www.FormsBoss.com; Impressive Publishing, LLC 800-208-1977