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HomeMy WebLinkAbout568067 WHAYNE AND SONS ENTERPRISES - INSURANCE CERTIFICATEWHAY&SO-01 JENNIFEREN .ACORu CERTIFICATE OF LIABILITY INSURANCE DATE7/3/2DD,1'YYY) /3/2019 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 Forsberg Engerman Company an affiliate of Mountain West Insurance & Financial Services, LLC 3575 S Sherman Street Englewood, CO 80113 CONTACT Jennifer Engerman NAME PHONE FAX (A/C, No, Ext): (A/C, No): ADDRIE : jenniferen@mtnwst.com INSURERS AFFORDING COVERAGE NAIC # INSURERA:Em to er's Mutual Casualty Company 21415 INSURED INSURER B : Plnnacol Assurance 41190 Whayne and Sons Enterprises dba Whayne Enterprises INSURER C : Westchester Fire Insurance Co. 10515 E 40th Ave #103 INSURER D : INSURER E : Denver, CO 80239 INSURER F : COVERAGES CERTIFICATE NUMBER: RFVISInN NHMRFR- 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 LTRTYPE OF INSURANCE ADDL SUBR WV POLICY NUMBER POLICY EFF POLICY EXP (Y LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE X OCCUR X 4X75619 7/1/2019 I 7/1/2020 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED PREMISES a occurrence) $ 300,000 MED EXP (Any oneperson) $ 5,000 PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: X POLICY PRO LOC JECT GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP/OP AGG 2,000,000 $ $ OTHER. A AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident 1,000,000 $ X BODILY INJURY Perperson) $ ANY AUTO X 4X75619 7/1/2019 7/1/2020 BODILY INJURY Per accident $ OWNED SCHEDULED AUTOS ONLY AUTOS PROPERTY DAMAGE Per accident $ HIRED NON -AWNED AUTOS ONLY AUTOS ONLY A X UMBRELLA LIAB OCCUR EACH OCCURRENCE $ 5,000,000 X AGGREGATE $ EXCESS LIAB CLAIMS -MADE 4X75619 7/1/2019 7/1/2020 DED I X I RETENTION $ 10,000 Agregate $ 6,000,000 B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROP RIETOR/PARTNER/EXECU TIVE ❑ OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N / A 4157055 7/1l2019 7/1/2020 I PER OTH- ER E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 1,000,0001 $ E.L. DISEASE - POLICY LIMIT A Equipment Floater 4X75619 7/1/2019 7/1/2020 Leased/Rented 35,000 C General Liability G46852527002- POLLUTION 1/1/2019 1/1/2020 Aggregate 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may, be attached if more space is required) City of Fort Collins is included as an Additional Insured with respect to General Liability and Auto Liability as required by written contract. City of Fort Collins 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 ACORD 25 (2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD