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APEX SIGN CO LLC DBA AD LIGHT & SIGN LLC - INSURANCE CERTIFICATE (5)
,ouzo® CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DDNYYY) 07/19/2019 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 INSURERS), 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 endorsementls). PRODUCER Pinnacol Assurance 7501 E. Lowry Blvd. Denver, CO 80230-7006 Pinnacol Assurance INSURED Apex Sign Co LLC dba Ad Light + Sign LLC 4150 Elati St Denver, CO 80216 COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: NALC t 41190 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. ILTRR TYPE OF INSURANCE ADDLiSUSR POLICY NUMBER MM/DDf EFF MPMIIDD EXP LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMS -MADE OCCUR PREMISES a occurrence $ MED EXP (Any one person) t PERSONAL d ADV INJURY $ GEWL AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE S POLICY ECT LOC PRODUCTS-COMPIOPAGG S S OTHER: AUTOMOBILE LIABILITY OMBIN INGLE LIMI a accident S $ ANY AUTO BODILY INJURY (Per person) OWNED F SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Per accMeril) S HIRED NON -OWNED AUTOS ONLY AUTOS ONLY PROPERTY DAMAGE (Per ectldent) S $ UMBRELLA UAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LL48 CLAIMS -MADE DIED RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILItt ANYPROPRIETOR/PARTNER/EXECUTIVE YIN A OFFICERMIEMBEREXCLUDED? O (Mandatory in NH) NIA 4030285 08/01/2019 08/01/2020 ER X I STATUTE ER E.L. EACH ACCIDENT $1.000,000 E.L. DISEASE- EA EMPLOYEE $1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT $1,000,000 7 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Unless otherwise stated in the policy provisions, coverage in Colorado only. Refer to the Acord 101 Additional Remarks Schedule for supplemental cancellation notification information. 2011044 City of Ft. Collins, Purchasing Division ATTN: James B O'Neill, II P O Box 580 Fort Collins, CO 80522-0580 LIT-1 ; L" R 01 W-11I Lei `I 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 Flood and Peterson/ Denver ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD M. ACORDs provided by Forms Boss. www.FormsBoss.com, (c) Impressive Publishing 800-208-1977