HomeMy WebLinkAbout111347 HAMILTON LAUNDRY COMPANY - INSURANCE CERTIFICATE (6)AR" CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDD/YYYY)
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: FAX
Hays Companies Inc. PHONE (816) 474-3535 (816) 842-5795
(A/C, No, Ext):- ----(A/C. Nam: -5795
1200 Main Street, Suite #2310 ADDRESS: lrobb@haysaompanies.com
INSURERIS) AFFORDING COVERAGE NAIL III
Kansas City MO 64105 INSURER A:Old
INSURED Hamilton Laundry Company INSURERB:Trs
Faultless Laundry Company, Inc INSURERC:
330 West 19th Terrace INSURER0:
Casualtv Co
24147
INSURER E :
Kansas City MO 64108 INSURERF:
r+nvcDAe_cc rST./AT./WC/TTT.. 15 19/20 RFVIRIr)N NIIMRFR-
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.
INS-
LIMITS
LTR TYPE OF INSURANCEIIRF POLICY NUMBER MMLDD/VYFYY MMLDD/YYYY
x ' COMMERCIAL GENERAL LIABILITY
EACH OCCURRENCE
$ 1,000,000
DAMAGETO RENTED
500,000
A CLAIMS -MADE � OCCUR
PREMISES (Ea occurrence)_
$
MWZY 312199 3/1/2019 3/1/2020
MED EXP (Any one person)
$ 10,000
PERSONAL & ADV INJURY
$ 1, 000 , 000
GEN'L AGGREGATE LIMIT APPLIES PER:
GENERAL AGGREGATE
$ 2,000,000
X POLICY u PRO- LOC
JECT
PRODUCTS -COMP/OP AGG
$ 2, 000 , 000
-
-
$
_,
OTHER:
AUTOMOBILE LIABILITY
COMBINED nt SINGLE LI IT
Ea accide
$ 1,000,000
$
% ANY AUTO
BODILY INJURY (Per person)
_ _
$
--
A
ALL OMED �— - SCHEDULED
MWTB 312198 3/1/2019 3/1/2020 BODILY INJURY (Per accident)
AUTOS ,_ AUTOS
NON -OWNED
P15--id ntDAMAGE
$
X X
HIRED AUTOS AUTOS
-(
$ 1, 000
X
Com Coll Ded
X
UMBRELLA LIAB X OCCUR
EACH OCCURRENCE
$ 15,000,000
AGGREGATE
$ 15,000,000
B
EXCESS LIAB CLAIMS -MADE
DIEDX RETENTION 10 000
$
ZUP-14P64533-19-NF 1 3/1/2019 3/1/2020
WORKERS COMPENSATION
X PER TH-
STATUTE_ ER
______ -
AND EMPLOYERS' LIABILITY IN
Y❑
_
ANY PROPRIETOR/PARTNER/EXECUTIVE
E.L. EACH ACCIDENT
$ 11000,000
$ 1,000,000
AOFFICER/MEMBER
EXCLUDED? NIA
(Mandatory in NH)
13
MWC 312200 3/1/209 /1/2020
E.L. DISEASE - EA EMPLOYEE
S 1 000 ODD
H yes, describe under
DESCRIPTION OF OPERATIONS bola w
F.. L. OISF_ASE - POLICY LIMIT
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
r"CDTICIr'ATC unl nFD 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 1988-2U14 ACORD GOKNOKA I ION. All rlgnts reservea.
ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD
INS025 (201401)