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HomeMy WebLinkAbout568067 WHAYNE ENTERPRISES - INSURANCE CERTIFICATE (2)WHAY&SO-01 GENEV ACORl� CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 1/3/2019 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 Forsberg Engerman Company an affiliate of Mountain West Insurance & Financial Services, LLC 3575 S Sherman Street Englewood, CO 80113 Whayne and Sons Enterprises dba Whayne Enterprises 10515 E 40th Ave #103 Denver, CO 80239 Diane Davis Ectp (303) 762-1717 ju , Nol:(303) 762-1733 INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: 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 TYPE OF INSURANCE JADIX UM SUER WyD POLICY NUMBER POLICryYFF POLICY EXPLTIR VDDIYYM LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE X OCCUR X 4D75619 7/1/2018 7/1/2019 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED PREMI$E$.jEaPer urrence MED EXP (Any one on $ 100,000 $ 5,000 PERSONAL& ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: X POLICY ❑ ja LOC OTHER GENERAL AGGREGATE $ 2,000,006 PRODUCTS - COMPIOP AGG $ 200,000 A AUTOMOBILE LIABILITY ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS AUTOS ONLY X AUOTNO ONLDD X 4E75619 7/1/2018 7/1/2019 CO (EaeB�klentlMINED LE LIMIT $ 1,000,000 X BODILY INJURY Perperson) $ X BODILYBjORtDILY INJURY Per accident $ PP�eccider%AMAGE $ A X UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE 4J75619 7/1/2018 711/2019 EACH OCCURRENCE $ 61000,000 AGGREGATE $ 5,000,000 DIED I X I RETENTION $ 10,000 B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE YJN Q,FICER/MEMBEER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N /A 4157055 7/1/2018 7/1/2019 X I PER OTH- UTE ER E.L. EACH ACCIDENT 11000,000 $ E.L. DISEASE - EA EMPLOYEE 1,000,000 E.L. DISEASE - POLICY LIMB 11000,000 q C Inland Marine General Liability 4C75619 G46852527002- POLLUTION 7/1/2018 1/1/2019 711/2019 1/1/2020 Leased/Rented Aggregate 35,000 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached H more space Is required) City of Fort Collins is included as an Additional Insured with respect to General Liability and Auto Liability as required by written contract. 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 ACORD 25 (2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD