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HomeMy WebLinkAboutED CARROLL MOTOR COMPANY INC - INSURANCE CERTIFICATE (4)A� p® DATE (MM DD YYYY)
CERTIFICATE OF GARAGE INSURANCE 02/20/2019
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(es) 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
CONTACT Sentry Customer Service
NAME:
� FAX
CNNo, Ezt: 800-473-6879 No: 800-514-7191
Beth Tenan
EMAIL ADDRESS: businessproducts_directdsortry.com
INSURER(S) AFFORDING COVERAGE
NAIC #
INSURER A : Sentry Select Insurance Company
21180
INSURED
INSURER B :
Ed Carroll Motor Company Inc
3003 S College Ave
INSURER C :
INSURER D :
Fort Collins, CO 60525-2535
INSURER E :
INSURER F :
rnv�owr_�c aRnn I('[ ISTOMFR In- CERTIFICATE M: 1042942 REVISION N:
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
LTA
TYPE OF INSURANCE
ADDL
INSRD
SUER
WVD
POLICY NUMBER
POLICY EFF
(MM/DD/YYYY)
POLICY EXP
(MM/DD/YYYY)
LIMITS
A
GARAGE LIABILITY" HIRED AUTOS
X ANY AUTO ONLY
Ll NON -OWNED
OWNED AUTOS USED
AUTOS ONLY IN GARAGE
BUSINESS
2557028004
03/01/2019
03/01/2020
AUTO ONLY (Ea accident)
$ 500,000
OTHER THAN
Y
AUTO ONLY
EA ACCIDENT
$ 500,000
AGGREGATE
$ 2,500,000
A
GARAGE KEEPERS LIABILITY
LEGAL LIABILITY
X DIRECT BASIS
X PRIMARY EXCESS
2557028004
03/01/2019
03/01/2020
X
CTOC P / LOG
SPECIFIED LOG
1
$ 920,000
$
X COLLISION LOG
LOG
1
$ 920,000
$
COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE OCCUR
EACH OCCURRENCE
$
DAMAGE TO RENTED
PREMISES a occurrence
$
GEN'L
MED EXP (Any one person)
$
PERSONAL & ADV INJURY
$
AGGREGATE LIMIT APPLIES PER:
POLICY ❑ PRO- El LOG
JECT
OTHER
GENERAL AGGREGATE
$
PRODUCTS - COMP/OP AGG
$
$
A
X UMBRELLA LIAR
X EXCESS LIAR
X
OCCUR
CLAIMS -MADE
2557028005
03/01/2019
03/01/2020
EACH OCCURRENCE
$ 5,000,000
AGGREGATE
$ 15,000,000
DED I I RETENTION $
PRODUCTS - CAMP/OP AGG
$ 15,000,000
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY
ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICER/MEMBER EXCLUDED? Y / N
(Mandatory in NH) ❑
If yes, describe under
REMARKS below
N / A
PERT
TUTE �RH
E.L. EACH ACCIDENT
$
E.L. DISEASE - EA EMPLOYEE
$
E.L. DISEASE - POLICY LIMIT
$
REMARKS (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
Refer to attached
nr=RTrCICATG unl DFR CANCFI I ATION
City of Fort Collins Risk Management
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
PO Box 580
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE
Fort Collins, 00 80522-0580
WITH THE POLICY PROVISIONS.
AU RIZ ESENTAJI /�
IJ
ACORD 30 (2016/03)
2557028
Sentry Select Insurance Company
1 00001 0000006882 19051 0 N
Page 1 of 2 © 2010-2015 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD 02/20/2019
B6538A7D-5199-448B-6594-997350D55857
0027020044348842619880522058080
AGENCY CUSTOMER ID: )0000(X2801
,aco�zo®
AGENCY
Beth Tenan
POLICY NUMBER
2557028004
CARRIER
Sentry Select Insurance Company
Ar1r11TIANAI RFMARKS
LOC #: —
ADDITIONAL REMARKS SCHEDULE
NAMED INSURED
Ed Carroll Motor Company Inc
NAIC CODE
21180 1 EFFECTIVE DATE: 03/01/2019
Page 2 of 2
ACORD 101 (2008/01) © 2008 ACORD CORPORATION. All rights reserved.
2557028 The ACORD name and logo are registered marks of ACORD 0212012019
Sentry Select Insurance Company