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HomeMy WebLinkAbout167490 PEAD AUDIO VISUAL LLC DBA SCOTT BESTICK - INSURANCE CERTIFICATEPEAKAUD-01
HPAYNE
i4CaR© CERTIFICATE OF LIABILITY INSURANCE
(✓-
DATE(M
5/30/201YYY)
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:
Carver and Associates Insurance Services, Inc.
17710 Ralston Road
Arvada, CO 80002
PHONE FAX
(A/C, No, Ext): (303) 420-1637 (A/C, No):(303) 431-9237
ADDRESS:
INSURERS AFFORDING COVERAGE
NAIC #
INSURER A: Travelers
36161
INSURED
INSURER B :
Peak Audio Visual, LLC dba
Scott Bestick
INSURER C:
700 West Mississippi Ave, Bldg
INSURER D:
INSURER E:
Denver, CO 80223
INSURER F :
COVERAGES CERTIFICATE NUMBER: 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
LTR
TYPE OF INSURANCE
ADDL
INSD
SUBR
WVD
POLICY NUMBER
POLICY EFF
MM/DD/YYYY
POLICY EXP
MM/DDIYYYY
LIMITS
A
X
COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE X OCCUR
X
680654OB135
2/18/2019
2/18/2020
EACH OCCURRENCE
$ 1,000,000
DAMAGE TO RENTED
PREMISES Fa occurrence
300,000
S
MED EXF (Any one person
S 5,000
PERSONAL & ADV INJURY
$ 1,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
POLICY ❑X JET ❑ LOC
GENERAL AGGREGATE
$ 2,000,000
PRODUCTS -COMP/OP AGG
$ 2,000,000
$
OTHER
AUTOMOBILE
LIABILITY
COMBINED SINGLE LIMIT
Ea accident
$
BODILY INJURY Perperson)
$
ANY AUTO
OWNED SCHEDULED-
-
-- -
AUTOS ONLY AUTOS
-
BODILY INJURY Per accident
$
PROPERTY DAMAGE
Per acC dent
$
HIRED NON -OWNED
AUTOS ONLY AUTOS ONLY
$
A
X
UMBRELLA LAB
OCCUR
EACH OCCURRENCE
$ 4,000,000
AGGREGATE
S
EXCESS LAB
CLAIMS -MADE
CUP0576T235
2/18/2019
2/18/2020
DED X RETENTION $ 5,000
$ 4,000,000
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY Y / N
PER OTH-
STATUTE I I ER
ANY PROPRIETOR/PARTNER/EXECUTIVE ❑
OFFICER/MEMBER EXCLUDED?
(Mandatoryin NH)
I. yes, descriLe order
N / A
E.L. EACH ACCIDENT
$
E L DISEASE - EA EMPLOYE
$
DESCRIPTION OF OPERATIONS below
E.L. DISEASE - POLICY LIMIT
S
A
BOP Liability
680654OB135
2/18/2019
2/18/2020
Hired and non -owned
1,000,000
I
DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
All Projects of the insured - City of Fort Collins Is additional insured if required by written contract.
[y3CalliChL\��iC�lA�la
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
City of Fort Collins Purchasing and Risk Management THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
y g g 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