HomeMy WebLinkAboutALL STRIPES & MAINTENANCE LLC DBA ROCKY MOUNTAIN S - INSURANCE CERTIFICATEAC40RO® CERTIFICATE OF LIABILITY INSURANCE DATE (MM DDf YYY)
L 7/26/2019
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 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 NAME: DAVE L WIEGAND
DAVE L WIEGAND (07280) PHONE FAX
2625 REDWING DR STE 170 c . 970.416-Me N,; 97D-418-5890
FORT COLLINS, CO 80526-0000 nDDRe : DAVID.WIEGANDQ000NTRYFINANCIAL.COM
Mutual Insurance
INSURED 5609501
ALL STRIPES 8 MAINTENANCE LLC DBA ROCKY MOUNTAIN SWEEPING
35943 STATE HWY 257
WINDSOR, CO 80550
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.
R
LTJIM
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFF
POLICY EXP
L
ADAMAGE
GENERAL LIABILITY
✓ COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE F—VI OCCUR
AB9286234
/17/2019
IlFCT
7/17/2020
EACH OCCURRENCE
S 1 000 000
$
TO RENTI:T,)
PREMISES Ea oaurr n
MED EXP (Any tar
$10 000
$1 000 000
PERSONAL a ADV INJURY
_
GEMLAGGREGGATE LIMIT APPLIES PER.
✓ POLICY I PRO- LOC
GENERAL AGGREGATE
$
PRODUCTS-COMP/OP AGG
_
52000DOO
AAUTOBODILY
78'WLELIABILITYAB9286234
ONEDSCHEDULED
OSs� AUTOS
NON -OWNED
ED AUTOS AUTOS
7/17/2019
/17/2020
_ Ea a�deent) ED SINGLE LIMIT$1,000,000
INJURY (Per person)
S
$
S
BODILY INJURY(Per adWW)
PROPERTY DAMAGE
ffw acd
f
UMBRELLA LUIB OCCUR
EXCESS LIAR CLAIMS -MADE
EACH OCCURRENCE
S
i _
S
AGGREGATE
DIED RETENTIONS
WORKERS COMPENSATION
AND EMPLOYERS'LIABILRY YIN
ANY PROPRIETORIPARTNERIEXECUTIVE
OFRCER/MEMBER EXCLUDED? ❑
(Mandatory In NH)
N yes describe under
DESCRIPTION OF OPERATIONS below
MIA
I WCSTATU- 1 OTH-
TORY LIMITS ER
E.L. EACH ACCIDENT
3
E.L. DISEASE - EA EMPLOYEE
S
S
E.L. DISEASE- POLICY LIMIT
DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space Is required)
THE CITY OF FORT COLLINS
PURCHASING DEPARTMENT
P O BOX 580
FORT COLLINS, CO 80522
IIPIC.
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
Oc 1988.2010
TION. All rights reserved.
ACORD 25 (2010/05)
The ACORD name and logo are registered marks of ACORD