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HomeMy WebLinkAboutINLET STRUCTURES INC - INSURANCE CERTIFICATE (4)INLESTR-01 MARSH1 AcoRO CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY) 3112/2019 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 k%JAcT Shaieen Martin SIX & Geving Insurance, Inc. PHONE FAX 225 Union Blvd. #575 Arc, No,Eld: (720) 962-0930 No:(720) 962-0942 Lakewood, CO 80228Miss: smartin iX ving.com INSURER(S) AFFORDING COVERAGE NAIC # INSURED Inlet Structures Inc. Danny & Rachel Garza 5110 York St rNSURER Denver, CO 80216 /`CDTIClf`ATC IJI IU12=0• RFVISIAAI k111MR9:12• 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 ADDL SUBR' POLICY NUMBER POLICY EFF POLICY EXP LIMITS A X . COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 " CLAIMS -MADE X OCCUR - X 3X23855 6/2/2018 6/2/2019 DAMAGE TO RENTED 300,000 MISE (Ea occurrence) -,. $ _ MED EXP (Any oneperson) $ 51000 PERSONAL & ADV INJURY $ 11000,000 AGGREGATE LIMIT APPLIES PER: POLICY L ^ J JECT LOC GENERAL AGGREGATE 2,000,000 GEN'L PRODUCTS - COMP/OP AGG 2,000B000 OTHER: A AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident) 1,000,000 $ BODILY INJURY Per n. X ANY AUTO 3X23855 W2/2018 6/=19 BODILY INJURY Per accident OWNED SCHEDULED AUTOS ONLY AUTNOSyy F PmJRdeT nt AMAGE E ZRS ONLY AUTOS ONLDY L A X UMBRELLALIAB X OCCUR EACH OCCURRENCE $ 5,000,000 EXCESS LIAB CLAIMS -MADE 3X23855 6=018 6/2/2019 -AGGREGATE $ 5,000,000 DED X RETENTION $ 10,000 B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY / ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory In NH) N / A 4018512 4/1/2019 4/1/2020 X I PER OTH- TUTE— -�-- E.L. EACH ACCIDENT 1,000,000 $ E.L. DISEASE - EA EMPLOYE 1,000,000 E.L. DISEASE - POLICY LIMMT 00� 000 if yes, describe under DESCRIPTION OF UPERAT IONS below DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) City of Fort Collins is named as additional insured as respects General Liability if required by written contract. II;V:NIRelaG1 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Fort Collins THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Y ACCORDANCE WITH THE POLICY PROVISIONS. P.O. Box 580 Fort Collins, CO 80522 AUTHORIZED REPRESENTATIVE ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD