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Home My WebLink AboutKOBOBEL FIRE PROTECTION LLC - INSURANCE CERTIFICATEAC�R�a CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDD/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 Gabriel Negron-Rodriguez NAME: Moody Insurance Agency, Inc. q/CC No Ext : (303) 824-6600 Fn c, No): (303) 370-0118 E-MAIL certrequest@moodyins.com ADDRESS: 8055 East Tufts Avenue INSURER(S) AFFORDING COVERAGE NAIC # Suite 1000 INSURERA: Llyods of London Denver CO 80237 INSURED INSURER B : Selective INSURER C : Pinnacol Assurance 41190 Kobobel Fire Protection, LLC INSURER D : Tokio Marine HCC 2329 E Mulberry St INSURER E : INSURER F : Fort Collins CO 80524 COVERAGES CERTIFICATE NUMBER: 19-20 Master 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 CONTRACTOR 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 ADDLSUBR INSD WVD POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MMIDD/YYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE ,000,000 $ 1DAMAGE CLAIMS-MADEFX] OCCUR PREM SESOEa occ."ence $ 100,000 MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $ 1,000,000 A FSG00062701 07/01/2019 07/01/2020 GEN'LAGGREGATE LIMITAPPLIES PER: GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP/OPAGG $ 2,000,000 POLICY N PRO- JECT ElLOC $ OTHER. AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ 1,000,000 BODILY INJURY (Per person) $ ANYAUTO B OWNED X SCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED X AUTOS ONLY !� AUTOS ONLY S2304994 05/01/2019 07/01/2020 BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ Medical Payment $ 5,000 X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 2,000,000 A IEXCESS LAB CLAIMS -MADE FS000029701 07/01/2019 07/01/2020 AGGREGATE $ 2,000,000 DED I X RETENTION $ 10,000 $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y/ N ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ OFFICER/MEMBER EXCLUDED? (Mandatory in NH) N/A 4124333 07/01/2019 07/01/2020 X STATUTE ER E.L EACHACCIDENT 1,000,000 $ E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE - POLICY LIMIT 1,000,000 $ If yes, describe under DESCRIPTION OF OPERATIONS below D Professional Liability Pollution Liability HCC1966866 07/01/2019 07/01/2020 Limit 1,000,000 Limit 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) 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. PO Box 580 AUTHORIZED REPRESENTATIVE Fort Collins CO 80523 ✓ /�7 @ 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD