HomeMy WebLinkAbout111347 HAMILTON LAUNDRY COMPANY - INSURANCE CERTIFICATE (5)Ow DATE (MM/DD/YYYY)
,a�oizo CERTIFICATE OF LIABILITY INSURANCE
2/28/2019
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 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 --
NAME:
Ha S Com anies Inc. PHONE (816)474-3535 FAX (816) 842-5795
—. LCOl
Y P (A/C, No, Ext): -- �_-N------ - — -
1200 Main Street, Suite #2310 ADDRESS:lrobb@hayscompanies.com
INSURER(SI1 AFFORDING COVERAGE NAIC#
Kansas City MO 64105 INSURERA:Old Republic Insurance Company_ 24147
INSURED Hamilton Laundry Company INSURERB:TraV_e_lers Property Casualty Co of 25674 _
Faultless Laundry Company, Inc INSURER C:—
330 West 19th Terrace INSURERD:
INSURER E :
Kansas City MO 64108 INSURER F:
/11=DTI1=I!`AT1: A11111AMr:D44i M r_T./AT./WC/TTT. 1 19/20 RFVISION N(IMRFR:
vTHIS 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 - ADDL SUER - -
- POLICY EFF POLICY EXP LIMITS
LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER
MM/DD MM/DD/VYYY
X COMMERCIAL GENERAL LIABILITY
EACH OCCURRENCE $
1,000,000
1
DAMAGE TO RENTED
$
500,000
A CLAIMS -MADE X OCCUR
PREMISES (Ea occurrence)_ _
_
_
X MWZY 312199
3/1/2019 3/1/2020 MED EXP (Any one person) $
--
10,000
—
I PERSONAL 8 ADV INJURY $
1,000,000
_
GEN'L AGGREGATE LIMIT APPLIES PER:
GENERAL AGGREGATE $
2 , 000 , 000
X POLICY PRO LOC
JECT
PRODUCTS - COMPlOPAGG $ _
2,000,000
OTHER
COMBINED SINGLE LIMIT $
1, 000, 000
A
AUTOMOBILE LIABILITYaccident)
(Ea accident)_ _- __..
._-__._
X
BODILY INJURY (Per person) $
ANY AUTO
ALL OWNED ISCHEDULED
MFITH 312198
3/1/2019 3/1/2020 BODILY INJURY (Per accident) $
AUTOS AUTOS
NON -OWNED
-'-
PROPERTY DAMAGE $
X HIRED AUTOS X ;AUTOS
(Per accident) _—_ _
Comp/Coll Ded $
1,000
X UMBRELLA LIAB X OCCUR
EACH OCCURRENCE —�—
$ --
_ 1L000 L000_
—
AGGREGATE
$
1-,000,_000
EXCESS LIAB
B CLAIMS -MADE
$
DED X RETENTION$ 10,000 ZUP-14P64533-19-NF 3/1/2019 3/1/2020
WORKERS COMPENSATION
R PER O H-
STATUTE_
iAND EMPLOYERS' LIABILITY Y / N
--
E.L. EACH ACCIDENT
$
11000 f 000.
ANY PROPRIETOR/PARTNER/EXECUTIVE f
OFFICER/MEMBER EXCLUDED? N/A
_
A (Mandatory in NH)
D1WC 312200
3/1/2019 3/1/2020
E.L.DISEASE - EA EMPLOYE
$ _
1,000,000
E.L. DISEASE - POLICY LIMIT
$
1,000,000
If yes, describe under
DESCRIPTION OF OPERATIONS below
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
As respects General Liability, City of Fort Collins
is included as Additional Insured as required by
written contract.
1171 `ATC unl ncD CANCFI I ATION
City of Fort Collins
PO Box 580
Ft. 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
s Hays/LROBB
U 1988-ZU14 AUUKU UUNHUFCA I IUN. An rlgnts reservea.
ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD
INS025 (201401)