HomeMy WebLinkAbout340571 MAX FIRE APPARATUS INC - INSURANCE CERTIFICATE (8)A�CORO®
lft. CERTIFICATE OF LIABILITY INSURANCE
DATE (MMIDD/YYVY)
3/29/2019
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
Commercial Risk Solutions
6600 E Hampden Ave Ste 200
Denver CO 80224
CONTACT
NAME: Amber Hernandez_
PHONE FAA!cX No : 303-757-7719
m 303-996-7861
ADDRESS: Ahernandez crsdenver.com
tNSURFJiBII FFORDINOCOVEIR
A - - ----
INSURER A: AUTO -OWNERS
NAIC#
h- ---
i 18988
INSURED MAXFI-1 —
Max Fire Apparatus, Inc.
P.O. Box 1658
INSURER 8.:.,.
-
INSURERC:
INSURERD:
Castle Rock CO 80104
_INSURER Ems__—_14—__
INSURER F :
COVERAGES CERTIFICATE NUMBER:1787404014 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 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 tSIL 069.._
LTR TYPE OF INSURANCE POLICY NUMBER
�_-POLICY EFF POUCY E(P _..___.
AA1lID /YYYY MM D/YYYY LIMITS
A
X ,COMMERCIAL GENERAL LIABILITY
J CLAIMS -MADE i_X : OCCUR
J
I Y
74125517
3/14/2019
3/14/2020
EACH OCCURRENCE
P MIS E1 occurrgnc
$ 1,000,000
$ 300,000-
$ 10,000
_ME[EXP (Any onaperson)
-
PERSONAL & ADV INJURY
$1,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
GENERAL AGGREGATE
$ 2,000,000
PRO-
X POLICY JECT LOC
PRODUCTS_COMP/OP AGG
$ 2,000,000
$
OTHER:
A
AUTOMOBILE LIABILITY
Y
4960687101
$/'1712019
3/172020
BINED SINGLE LIMIT
$ 1 000 000
BODILY INJURY (Per person)
$
X ANY AUTO
OWNED SCHEDULED
AUTOS ONLY AUTOSNCNOWN
BODILY INJURY (Per accident)
$
eacf0 i
P�a_dDAMAGE
-
$-AUTOS
D
HIRED AUTOS ONLY
ONLY X
$
UMBRELLALIAB
tDCCUR
EACHOCCURRENCE
$
AGGREGATE
$
EXCESS LIAB
CLAIMS -MADE
DIED RETENTION
$
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY YIN
ANYPROPRIETOWPARTNER/EXECUTIVE
OFFICER/MEMBER EXCLUDED?
(Mandatory In NH)
It yes. describe under
DESCRIPTION OF OPERATIONS below
NIA
!
i I PT$ ATUTE _.. ERH
E.L. EACH ACCIDENT
— — --
.. NO COVERAGE _-.
$ --
E.L. DISEASE - EA EMPLOYEE
$
E.L. DISEASE - POLICY LIMIT
$
A Garage & Dealers 4960687100
3/14/2019 3/142020
; Each Accident
Aggregate
1,000,000
I 2,000,000
Med Pay
10,000
DESCRIPTION OF OPERATIONS i LOCATIONS 1 VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached it more space is required)
Re: 7563 PFA Fire Apparatus- Pumper.
City of Fort Collins is included as additional insured for ongoing operations on the General Liability and included as additional insured on the Auto Liability with
respect to operations of the named insured for the certificate holder as required by written contract. All policy terms, conditions and exclusions apply.
CERTIFICATE HOLDER CANCELLATION
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.
Purchasing Department
AUTHORIZED REPRESENTATIVE
P.O. BOX 580
Fort Collins CO 80522
A4�)fi 77�
01988-2015 ACORD CORPORATION. All rights reserved.
ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD
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