HomeMy WebLinkAbout543624 HEAD FIRST BIOLOGICAL LLC - INSURANCE CERTIFICATEA`�RO®
CERTIFICATE OF LIABILITY INSURANCE
DATE (MMlDDlVYYl)
6/11/2019
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
Secure American Insurance
Lance Leivestad
2105 Maple Drive
Loveland CO 80538
NAME: Rachel Rogers
PHOE FAA
'C, No, Ezt : 970-663-9197 (A/C, No): 970-237-3412
ADDRESS: rachel@yoursai.com
INSURER(S) AFFORDING COVERAGE
NAIC #
INSURER A: AUTO OWNERS INS CO
18988
INSURED
Head First Biological LLC
4690 Wisconsin Ave
Loveland CO 80538-6833
INSURER B :
INSURER C :
INSURER D :
INSURER E:
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.
LTR
TYPE OF INSURANCE
INSD
WVD
POLICY NUMBER
(MM/DD/YYYY)
(MM/DD/YYYY)
LIMITS
A
X
COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE � OCCUR
74743017
06/18/2019
06/18/2020
EACH OCCURRENCE
$ 1,000,000
PREMISES (Ea occurrence)
$ 300,000
MED EXP (Any one person)
$ 10,000
PERSONAL & ADV INJURY
$
GEN'L AGGREGATE LIMIT APPLIES PER.
POLICY ❑ PRO- ❑
JECT LOC
OTHER:
GENERAL AGGREGATE
$ 2,000,000
PRODUCTS - COMP/OP AGG
$ 2,000,000
$
AUTOMOBILE LIABILITY
ANY AUTO
OWNED SCHEDULED
AUTOS ONLY AUTOS
HIRED NON -OWNED
AUTOS ONLY AUTOS ONLY
(Ea accident)
$
BODILY INJURY (Per person)
$
BODILY INJURY (Per accident)
$
MAUE
(Per accident)
$
UMBRELLA LIAB
EXCESS LIAB
OCCUR
CLAIMS -MADE
EACH OCCURRENCE
$
AGGREGATE
$
DED RETENTION $
$
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY y / N
ANY PROPRIETOR/PARTNER/EXECUTIVE ❑
FFICER/MEMBER EXCLUDED?
Mandatory in NH)
f yyes, describe under
ESCRIPTION OF OPERATIONS below
N / A
-
STATUTE ER
E.L. EACH ACCIDENT
$
E.L. DISEASE - EA EMPLOYEE
$
E.L. DISEASE - POLICY LIMIT
$
DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
The City of Fort Collins is a certificate holder.
L91:I:1t1l2161na
The City of Fort Collins
Purchasing Department
PO Box 580
Fort Collins, CO 80522
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE
Ra.,:.bt.� R"ers
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