HomeMy WebLinkAboutSAFETY RAILS OF COLORADO INC - INSURANCE CERTIFICATE (3)ACOR I ®
CERTIFICATE OF LIABILITY INSURANCE
DATE (MM/)D/YYYY)
02/03/2019
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 Heather Lee
NAME:
Flood and Peterson
pA/CC, . Ext : (720) 977-6016 aC No : (970) 330-1867
E-MAIL HLee@FloodPeterson.com
ADDRESS:
PO Box 578
INSURER(S) AFFORDING COVERAGE
NAIC #
INSURERA: Liberty Mutual Insurance Cc
Greeley CO 80632
INSURED
INSURER B
INSURER C
Safety Rails of Colorado, Inc., Custom Fence & Supply, Inc.:
INSURER D :
Custom Leasing, Inc.
INSURER E :
3031 Highway 119
INSURER F :
Longmont CO 80504
COVERAGES CERTIFICATE NUMBER: COLORADO 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,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR
LTR
TYPE OF INSURANCE
ADDLSUBR
INSD
WVD
POLICY NUMBER
POLICY EFF
MM/DD/YYYY
POLICY EXP
MM/DD/YYYY
LIMITS
X
COMMERCIAL GENERAL LIABILITY
EACH OCCURRENCE
$ 1,000,000
CLAIMS -MADE � OCCUR
DAMAGE TO TED
PREMISES a olccurrence
$ 500,000
X
MED EXP (Any one person)
$ 10,000
$25,000 Deductible BI/PD
PERSONAL& ADV INJURY
$ 1,000,000
A
TB2-Z91-470145-029
02/01/2019
02/01/2020
GEN'LAGGREGATE LIMIT APPLIES PER:
GENERAL AGGREGATE
$ 2,000,000
POLICY PRO-
JECT LOC
PRODUCTS
$ 2,000,000
$
OTHER:
AUTOMOBILE LIABILITY
COMBINED SINGLE LIMIT
COMBINED
Eaccident
$ 1,000,000
BODILY INJURY (Per person)
$
X ANY AUTO
A
OWNED SCHEDULED
AUTOS ONLY AUTOS
AS2-Z91-470145-019
02/01/2019
02/01/2020
BODILY INJURY (Per accident)
$
PROPERTY DAMAGE
Per accident
$
HIRED NON -OWNED
XAUTOS ONLY !� AUTOS ONLY
UMBRELLA LIAB
OCCUR
EACH OCCURRENCE
$
AGGREGATE
$
EXCESS LIAB
CLAIMS -MADE
DED I I RETENTION $
$
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY y / N
PER OTH-
STATUTE ER
ANY PRO PRIETOR/PARTNER/EXEC UTIVE ❑
OFFICER/MEMBER EXCLUDED?
N/A
E.L. EACH ACCIDENT
$
(Mandatory in NH)
E.L. DISEASE - EA EMPLOYEE
$
If yes, describe under
DESCRIPTION OF OPERATIONS below
E.L. DISEASE - POLICY LIMIT
$
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
rFRTIFIrATF W01 nF:P rANrFI I ATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
City of Fort Collins
ACCORDANCE WITH THE POLICY PROVISIONS.
215 N Mason St
AUTHORIZED REPRESENTATIVE
Fort Collins CO 80522
M -
@ 1988-2015 ACORD CORPORATION. All rights reserved.
ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD