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HomeMy WebLinkAboutCOLORADO STANDBY LLC - INSURANCE CERTIFICATE1 RO ACOCERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 07/01/2019 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 Justin Nightengale, CRIS NAME: Moody Insurance Agency, Inc. A//CNr o Exc : (303) 824-6600 (FAX No): (303) 370-0118 E-MAIL hten ale justin nig g moody ins.com ADDRESS: @ 8055 East Tufts Avenue INSURER(S) AFFORDING COVERAGE NAIC # Suite 1000 INSURERA: Cincinnati Indemnity Company 23280 Denver CO 80237 INSURED INSURER B : Plnnacol Assurance 41190 INSURER C : Colorado Standby, LLC INSURER D : 720 Seedling Ct INSURER E : INSURER F : Colorado Springs CO 80915 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 REOVIREMEN T, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO AHICH 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. ILTR TYPE OF INSURANCE INSD WVD POLICY NUMBER MM DD/YYYY MM/DD/YYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 17X DAMAGE TO RENTED 100,000 CLAIMS -MADE OCCUR PREMISES Ea occurrence) $ MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $ 1,000,000 A Y Y ENP0509951 07/01/2019 07/01/2020 GEN'LAGGREGATE LIMITAPPLIES PER. GENERAL AGGREGATE $ 2,000,000 POLICY Fx_1 JECT PRO ❑ LOC PRODUCTS-COMP/OPAGG $ 2,000,000 $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ 1,000,000 BODILY INJURY (Per person) . $ ANYAUTO A OWNED X SCHEDULED Y Y ENP0509951 07/01/2019 07/01/2020 BODILY INJURY (Per accident) $ AUTOS ONLY AUTOS PROPERTY DAMAGE Per accident $ X HIRED NON -OWNED X AUTOS ONLY AUTOS ONLY $ X UMBRELLA LAB X OCCUR EACH OCCURRENCE $ 1,000,000 AGGREGATE $ 1,000,000 A EXCESS LAB CLAIMS -MADE ENP0509951 07/01/2019 07/01/2020 DED I X1 RETENTION $ 0 $ WORKERS COMPENSATION PER I X1 I AND EMPLOYERS' LIABILITY Y / N STATUTE I EERH E.L. EACH ACCIDENT 1,000,000 $ B ANY PROPRIETOR/PARTNER/EXECUTIVE N/A Y 4214133 01/06/2019 01/01/2020 1,000,000 OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE $ If yes, describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ Limit 25,000 Leased / Rented Equipment A ENP0509951 07/01/2019 07(01/2020 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) City of Fort Collins, its officers, agents and employees are Additional Insureds with regards to General Liability and Automobile Liability. A Waiver of Subrogation endorsement applies with regards to General Liability, Automobile Liability and Workers Compensation. 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. 215 N Mason St AUTHORIZED REPRESENTATIVE 2nd Floor, PO Box 580 Fort Collins CO 80522 © 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD