HomeMy WebLinkAbout340571 MAX FIRE APPARATUS INC - INSURANCE CERTIFICATE (9)ACC>R" ® 7DATE (MM/DD YYYY)
CERTIFICATE OF LIABILITY INSURANCE /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 CONTACT
NAME_ Amber Hernandez _
Commercial Risk Solutions PHONE 303-996-7861 Ac No:303-757-7719
6600 E Hampden Ave Ste 200 E-MAIL
Denver CO 80224 ADDRESS: Ahernandez crsdenver.com
INSURER(S)AFFORDING COVERAGE NAIC #
INSURER A: AUTO -OWNERS 18988
INSURED N' Arr i INSURER B :
Max Fire Apparatus, Inc. -...-____..._.._.___-.----___._.___..____---�- __-_-_-
P.O. Box 1658 INSURERC:
Castle Rock CO 80104 INSURER 0:
nr%VFRAr_FC C9=r2TIFICAT1= NI IMRFR•RFVISI(AN 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.
- - -r
---_ iA151)Li$U9R' XP
IN ICYYYY
-TYPE
OF INSURANCE--
R POLICY NUMBER MM/LDD MMrDD YYYY i LIMITS
A
X COMMERCIAL GENERAL LIABILITY
Y
74125517
3/14/2019
3/14/2020
EACH OCCURRENCE
$ 1,000,000
�X�
AIVA0_ET_0'A Tt _
$ 300,000
�—J CLAIMS -MADE LJ OCCUR
PREMISES (Ea oocurrenceL
MED EXP (Arry on person)
$10,000
PERSONAL & ADV INJURY
$1,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
PRO-
GENERAL AGGREGATE
$ 2 000 000
— --
X POLICY JECT —J LOC
PRODUCTS: COMP/OP AGG
$2 000 000
OTHER:
$
A
AUTOMOBILE LIABILITY
49ONS7101 3/17/2019
3/17/2020
COMBINED SINGLE LIMIT
$1,000,D00
-.---
BODILY INJURY (Per person)
$
X ANY AUTO
OWNED SCHEDULED
�
BODILY INJURY (Per accident)
$
AUTOS ONLY AUTOS
E PROPERTY DAMAGE
$
X HIRED x NON -OWNED
AUTOS ONLY AUTOS ONLY
UMBRELLALIAB OCCUR
'
EACHOCCURRE_NCE
$
AGGREGATE _
$
EXCESS LIAB CLAIMS -MADE
DED RETENTION $
$
WORKERS COMPENSATION
PTA ERH NO COVERAGE
AND EMPLOYERS' LIABILITY YIN
- --
ANYPROPRIETOR,PARTNEWEXECUTIVE
E.LEACH ACCIDENT $
--
OFFICERJMEMBER EXCLUDED?
N / A
-
(Mandatory In NH)
I
E.L. DISEASE - EA EMPLOYEE', $
------- —
If describe under
as,
. DESCRIPTION OF OPERATIONS below
E.L. DISEASE -POLICY LIMIT 1 $
A Garage & Dealers
1
4900887100 3/14/2019 i 3/14/2020 Each Accident 1,000,000
I ate 2,000,000
I
I
I
Medrep
y 10,000
DESCRIPTION OF OPERATIONS % LOCATIONS VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached it more space is required)
Re: Fleet Maintenance. City of Fort Collins is included as additional insured on the General Liability with respect to ongoing operations of the named insured for
the certificate holder as required by written contract. All policy terms, conditions and exclusions apply.
PCRTICICATC wni npo RANr`FI I ATInIJ
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
City of Fort Collins
P.O. Box 580
AUTHORIZED REPRESENTATIVE
Fort Collins CO 80522
U 1988-2015 ACORD CORPOHATION. All rights reserved.
ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD
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