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HomeMy WebLinkAboutLONG BUILDING TECHNOLOGIES INC - INSURANCE CERTIFICATE (2)AGORDrM CERTIFICATE OF LIABILITY INSURANCE
DATE(MM/DD/YYYY)
5/1/2020
4/26/2019
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 Lockton Companies
8110 E. Union Avenue
Suite 700
Denver CO 80237
CONTACT
NAME:
PHONEFAX
A/C No Ext : A/C No):
E-MAIL
ADDRESS:
INSURER AFFORDING COVERAGE
NAIC p
(303) 414-6000
INSURER A: The Charter Oak Fire Insurance Company
25615
INSURED LONG Building Technologies, Inc.
1409467 5001 South Zuni Street
Littleton, CO 80120
INSURER B : The Travelers Indemnity Company
25658
,ravelers Property Casualty Co of America
INSURER c : a y Y
25674
INSURER D :
1050.180527 - Fort Collins Bike Shelters
INSURER E :
INSURER F :
COVERAGES CERTIFICATE NUMBER- 15737699 RFVIRIrIN iJIIURFR• XXXXXXX
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
LTR
TYPE OF INSURANCE
ADDL
INSD
SUBR
NND
POLICY NUMBER
POLICY EFF
MM/DD/YYYYI
POLICY EXP
(MMIDDIYYYYI
LIMITS
A
X
COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE OCCUR
X
WA -WY -Stop Gan Intl
N
N
DTCOOH876035
5/1/2019
5/1/2020
EACH OCCURRENCE
1,000,000
DAMAGE TO RENTED
PREMISES Ea occurrence
3OO OOO
X
MED EXP (Any oneperson)
15,000
PERSONAL & ADV INJURY
$ 1,000,000
GEN'L AGGREGATE LIMIT APPLIES PER.
POLICY PRO- LOC
OTHER
GENERAL AGGREGATE
$ 2,000,000
PRODUCTS -COMP/OP AGG
$ 2,000,000
B
AUTOMOBILE
LIABILITY
ANY AUTO
OWNED SC
AUTOS ONLY AUTOSULED
HIRED NON -OWNED AUTOS ONLY X AUTOS ONLY(Per
N
N
DT8100H876035
5/l/2019
5/1/2020
COMBINED SINGLE LIMIT
Ea accident
$ 1,000,000
X
BODILY INJURY (Per person)
$ XXXXXXX
BODILY INJURY (Per accident
$ XXXXXXX
X
accident)T DAMAGE
$ XXXXXXX
$XXXXXXX
C
X
UMBRELLA LIAB
EXCESS LIAB
X
IOCCUR
CLAIMS -MADE
N
N
CUP3J93435726
5/l/2019
5/1/2020
EACH OCCURRENCE
$ 10.000 000
AGGREGATE
$ 10,000,000
DED I I RETENTION $ 10,000
$ XXXXXXX
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY Y1 N
ANY PROPRIETOR/PXCLUDE/EXECUTIVE �
OFFICER/MEMBER EXCLUDED?
(Mandatory in NH)
If yes, describe under
DESCRIPTION OF OPERATIONS below
N / A
N
UB4K46481A1826G
5/1/2019
5/1/2020
PER OTH-
X STATUTE ER
E.L. EACH ACCIDENT
f1
$ 500,000
E L. DISEASE- EA EMPLOYEE
500,000
E.L. DISEASE- POLICY LIMIT
500 000
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
6.Crx I Ir it pi, I C rIULUCR tANGtLLA I IUN See Attacrlments
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
15737699
AUTHORIZED REPRESENTATIVE
City of Fort Collins - Parking Services
PO Box 2047
Fort Collins CO 80524
ACORD 25 (2016/03) @ 1 988-20YS ACORb CORP RATION. All rights reserved
The ACORD name and logo are registered marks of ACORD