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HomeMy WebLinkAbout565996 BLACK EAGLE FENCE INC - INSURANCE CERTIFICATEBLACK06 MM/DAcoRO FDATE (23/2 Y01 05/3I29 9 CERTIFICATE OF LIABILITY INSURANCE 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 970-223-1804 CONTACT Front Range Insurance Group 2002 Caribou Drive, Ste. 101 PHONE 970-223-1804 FAX A/C, No, Ext): (A/C, No): E-MAIL Fort Collins, CO 80525 AssuredPartners Colorado INSURERS AFFORDING COVERAGE NAIC If INSURER A: Acuity, A Mutual Insurance INSURED Black Eagle Fence, Inc. PO BOX Z95 Loveland, CO 80539 INSURER B : Plnnacol Assurance 41190 INSURER C : INSURER D : 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 ADDUSUB POLICY NUMBER POLICY EFF POLICY EXPLTR LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE LX] OCCUR X Z67437 06/01/2019 06/01/2020 EACH OCCURRENCE $ 1,000,000 PREMISES DAMAGE T RENTED nte $ 100,000 MED EXP (Any oneperson) $ 5,000 PERSONAL & ADV INJURY $ 1,000,000 GEN1 AGGREGATE LIMIT APPLIES PER: pre- POLICY JE T LOC OTHER: GENERAL AGGREGATE $ 2,000,000 PRODUCTS -COMP/OP AGG 2,000,000 $ A AUTOMOBILE LIABILITY ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS AUTOS ONLY AUOTOS ONES X Z67437 06/01/2019 06/01/2020 CO aBcid.n SINGLE LIMIT $ 1 000 000 X BODILY INJURY Perperson) $ BODILY BODILY INJURY Per accident $ PR acc,dentDAMAGE $ A UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE Z67437 06/01/2019 06/01/2020 EACH OCCURRENCE $ 1,000,000 X AGGREGATE $ _ 1,000,000 DED X RETENTION$ 10,000 B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION F OPERATIONS below N/A 4148836 06/01/2019 06/01/2020 X PER OTH- STATUTER E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE S 1,000,000 E.L.DISEASE-POLICY LIMIT 1,000,000 i DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) CITYOFF City of Fort Collins Director of Purchasing & Risk Management PO Box 580 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 No Text