HomeMy WebLinkAbout122004 SHAMROCK TAXI OF FORT COLLINS INC - INSURANCE CERTIFICATE,�4�a® CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DDYWY) D6/26/2019 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 Aon Risk Services Central, Inc. Chicago IL Office CONTACT NAME: PHONE (866) 283-7122 FAX (800) 363-0105 (A/C. No. Ext): (A/C. No.): E-MAIL ADDRESS: 200 East Randolph Chicago IL 60601 USA INSURER(S) AFFORDING COVERAGE NAIC # INSURED INSURER A: Old Republic Insurance Company 24147 Shamrock Taxi of Fort Collins. Inc. 4414 East Harmony Rd., Suite 200 INSURER B: INSURER C: Fort Collins CO 80528 USA INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 570077087878 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. Limits shown are as requested LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER MM/DD/YYW) (MMJD`61YYYYl LIMITS A X COMMERCIAL GENERAL LIABILITY Y MWZY 1 1 1 EACH OCCURRENCE $1,000,000 CLAIMS -MADE X❑ OCCUR DAMAGERENTED$1,000,000 PREMISES Ea occurrence MED EXP (Any one person) $10 , 000 PERSONAL B ADV INJURY $1,000,000 GEN'LAGGREGATE LIMITAPPLIES PER: GENERAL AGGREGATE $1,000,000 X POLICY ❑ PRO JECT ❑ LOC PRODUCTS - COMP/OPAGG $1,000,000 OTHER: • AUTOMOBILE LIABILITY Mwzx 26684-19 EXc Of Statutory Limits 07/01/2019 07/01/2020 COMBINED SINGLE LIMIT Ea accident $1,000,000 BODILY INJURY ( Per person) A X ANYAUTO Y MWTB 21267-19 07/01/2019 07/01/2020 OWNED SCHEDULED Statutory Limits BODILY INJURY (Per accident) AUTOS ONLY AUTOS HIREDAU70S NON -OWNED ONLY AUTOS ONLY PROPERTY DAMAGE Per accident UMBRELLA LIAB EACH OCCURRENCE AGGREGATE EXCESS LIAB HOCCUR CLAIMS -MADE DED RETENTION A WORKERS AND EMPLOYERSOLIABIL LIABILITY YIN ANY PROPRIETOR/ PARTNER/ EXECUTIVE MWC31381919 Workers Comp 07/01/2019 07/01/2020 X STATUTE �RH E. L. EACH ACCIDENT $1,000,000 OFFICER/MEMBER EXCLUDED? ❑ N / A E.L. DISEASE -EA EMPLOYEE $1,000,000 (Mandatory in NH) If yco, desorbc under DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT $1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) The city, its officers, agents and employees are included as additional insured with respect to General Liability and Automobile Liability policies where required by written contract. CERTIFICATE HOLDER CANCELLATION 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 AUTHORIZED REPRESENTATIVE Attn: Craig Dublin PO Box 580 Fort Collins Co 80522 USA L d ro r` m cc 0 0 O r__ N ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD