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HomeMy WebLinkAboutTRANSPRO BURGENER TRUCKING INC - INSURANCE CERTIFICATEA� OF CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DDIYYYY) 05/28/2019 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 Stephanie Sloan, CIC NAME: Flood and Peterson a/c NNo Ext : (970) 356-0123 FAX NII: (970) 330-1867 PO Box 578 E-MAIL SSloan@floodpeterson.com ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC 0 Greeley CO 80632 INSURER A: Great West Casualty Co. 11371 INSURED INSURER B : Gemini Insurance Company 10833 Transpro, Inc., DBA: Burgener Trucking Inc. INSURER C : Pinnacol Assurance 41190 INSURER D : 7301 Sw Frontage Road, Suite 3 INSURER E : Fort Collins CO 80528 INSURER F : COVERAGES CERTIFICATE NUMBER: 2019-2020 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 ADUL INSD SUBR WVD POLICY NUMBER POLICY EFF MMfDD I POLICY EXP MMIDD LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE 1,000,000 $ CLAIMS -MADE ®OCCUR PREMISES Ea occurrence $ 100,000 MED EXP (Any one person) $ 5,000 PERSONAL &ADV INJURY S 1,000,000 A Y GWP61685K 06/01/2019 06/01/2020 GEN'LAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE S 2,000,000 POLICY JECOT- LOC PRODUCTS - COMP/OP AGG $ 2.000,000 $ OTHER, AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident S 1,000,000 BODILY INJURY (Per person) $ ANY AUTO A OWNED SCHEDULED AUTOS ONLY AUTOS Y GWP61685K 06/01/2019 06/01/2020 BODILY INJURY (Peraccident) 5 PROPERTY DAMAGE Per accident $ HIRED NON -OWNED AUTOS ONLY AUTOS ONLY Uninsured motorist $ X UMBRELLA LIAB OCCUR EACH OCCURRENCE S,000,OOO $ AGGREGATE 5 5,000,000 B EXCESS LIAB CLAIMS -MADE GVE100227001 06/01/2019 06/01/2020 LIv DED ^ RETENTION $ 10,000 $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETORIPARTNER/EXECUTIVE ❑ OFFICER/MEMBER EXCLUDED? (Mandatory In NH) NIA 4176705 06/01/2019 06/01/2020 X SPER TATUTE ERH E. L. EACH ACCIDENT 1,000,000 5 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT S 1,000,COC A Broad Form Cargo GWP61685K 06/01/2019 06/01l2020 Per Unit Limit $100,000 Retention/SIR $25,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required) Certificate holder is included as Additional Insured as required by written contract with respects to liability arising out of work performed by the named insured. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN The City of Fort Collins ACCORDANCE WITH THE POLICY PROVISIONS. PO Box 580 AUTHORIZED REPRESENTATIVE Fort Collins CO 80522 ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD