HomeMy WebLinkAboutFREEDOM FIRE PROTECTION LLC - INSURANCE CERTIFICATEACOR-1 0
�� CERTIFICATE OF LIABILITY INSURANCE
DATE (MM/DDIYYYY)
06/03/2019
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 Dana Stewart, CIC, CISR
NAME:
Flood and Peterson
AfCNNo Ext : (870) 266-7149� No): (970) 506-6845
E-MAIL DStewart@floodpeterson.com
ADDRESS:
PO Box 578
INSURER(S) AFFORDING COVERAGE
NAIL #
INSURER A: Cincinnati Insurance Co
10677
Greeley CO 80632
INSURED
INSURER B : Pinnacol Assurance
41190
INSURER C :
Freedom Fire Protection, LLC
INSURER D :
4026 Mulligan Drive
INSURER E :
INSURER F :
Longmont CO 80504
COVFRAGFS CERTIFICATE NUMBER: AU/WC x7/2020 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 CONTRACTOR 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
ADDLISUBR
INSD
WVD
POLICY NUMBER
POLICY EFF
MMIDD
POLICY EXP
MMIDD
LIMITS
COMMERCIAL GENERAL LIABILITY
EACH OCCURRENCE
$
E
CLAIMS -MADE 0 OCCUR
PREMISES Ea occurrence
$
MED EXP (Any one person)
$
PERSONAL&ADV INJURY
$
GEN'LAGGREGATE LIMIT APPLIES PER:
GENERAL AGGREGATE
$
PRODUCTS -COMP/OP AGG
$
POLICY ❑ PECOT- LOC
$
OTHER:
AUTOMOBILE LIABILITY
COMBINED SINGLE LIMIT
!Ea accident
$ 1,000,000
BODILY INJURY (Per person)
$
X ANY AUTO
A
OWNED SCHEDULED
AUTOS ONLY AUTOS
HIRED NON -OWNED
AUTOS ONLY AUTOS ONLY
ENP0393060
07101/2019
07/01/2020
BODILY INJURY (Pe accident)
$
PROPERTY DAMAGE
Per accidenH
$
$
UMBRELLA LIAB
OCCUR
EACH OCCURRENCE
$
4EXCESS
HCLAIMS-MADE
AGGREGATE
$
LIAR
DED RETENTION $
$
B
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY Y / N
ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICER/MEMBER EXCLUDED? El (Mandatory In NH)
NIA
4115479
07/0112019
07/01/2020
OTH-
X ER STATUTE
E.L. EACH ACCIDENT
$ 500,000
E.L. DISEASE - EA EMPLOYEE
$ 500,000
E.L. DISEASE - POLICY LIMIT
500,000
$
'f yes, describe ender
DESCRIPTION OF OPERATIONS below
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space is required)
M=I;4112L91aV
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.
P.O. Box 580
AUTHORIZED REPRESENTATIVE y�
Fort Collins CO 80522-0000w11
@ 1988-2015 ACORD CORPORATION. All rights reserved.
ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD