HomeMy WebLinkAbout102606 4 RIVERS EQUIPMENT LLC - INSURANCE CERTIFICATE (2)A CERTIFICATE OF LIABILITY INSURANCE DATE 08/02/20, YYYVy
/2019 9
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 CONSTIT&E 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 policyfies) must have ADDITIONAL INSURED provisions or be
endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions off tthhe policy, certain policies may require an endorsement. A
statement on this certificate does not confer nghts to the certificate holder in lieu of such endorsement(s).
PRODUCER
David Tirdel
CONTACT
NAM • Sentry Customer Sarvice
PHONE FAX
LAIC, No. • 800-473-6879 • 800-514-7191
EMAIL
ADDRESS: businasyroducts diract6sorttry.com
INSURER(S) AFFORDING COVERAGE
NAIC M
INSURER A: Sard y Select Insurance Company
21180
INSURED
INSURER B :
4 Rivers Equipment LLC DBA 4 Rivers Equipment
92411th St
INSURER C :
Greeley, CO 60631-4043
INSURER D :
INSURER E :
INSURER F
41
17,
cUVEHAUhS CERTIFICATE NUMBER: 1248439 REVISION NUMRFP-
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
ADDL
INSR
SUER
WVO
POLICY NUMBER
POLICY EFF
M/DD
POLICY EXP
M/DD
LIMITS
A
X
COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE FTJ OCCUR
2472581003
09/01 /2019
09/01/2020
EACH OCCURRENCE
$ 500.000
DAMAGE TO RENTED
PREMISES a ocaarence
$ 100 000
MED EXP (Any one person)
$ 5.000
PERSONAL 8 ADV INJURY
$ gOp,ppp
GENT
AGGREGATE LIMIT APPLIES PER:
POLICY F—] JECT 7 LOC
OTHER:
GENERAL AGGREGATE
$ 1,500.000
X
PRODUCTS - COMP/OP AGG
$ 1,500.000
A
AUTOMOBILE
LIABILITY
ANY AUTO
OWNED SCHEDULED
AUTOS ONLY AUTOS
HIRED NON -OWNED
AUTOS ONLY AUTOS ONLY
2472561004
09/01/2019
09/01/2020
COMBINED SINGLE LIMIT
(Ea accident)
$ 500,000
X
BODILY INJURY (Per person)
$
BODILY INJURY (Par accidenq
$
PROPERTY DAMAGE
(Par accident)$
A
X
UMBRELLA LIAR
EXCESS LIAR
X
OCCUR
CLAIMS -MADE
2472581005
09/01/2019
08/01/2020
EACH OCCURRENCE
$ 20,000,000
X
AGGREGATE
$ 60,000,000
DED I I RETENTION $
PRODUCTS - COMP/OP AGG
$ 60,000,000
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY Y / N
ANY PROPRIETOR/PARTNER/EXECUTNE❑
OFFICER/MEMBER EXCLUDED?
(Mondatory in NM
If yes, describe urMer
DESCRIPTION OF OPERATIONS below
N/A
pTH
STAT UTE ER
E.L. EACH ACCIDENT
$
E.L DISEASE - EA EMPLOYEE
$
EL DISEASE - POLICY LIMIT
$
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached it more space is required)
a.cn I Irla ^le nvs.Uen CANCPI I ATInm
City of Fat Collins
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
300 Laporte Ave
Fat Collins, CO 80521
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE
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MI Wnu L ICV 10/V3)
2472581
Sentry Select Insurance Company
1 00001 0000015243 19218 0 N
I -age 1 of 2 (91988-2015 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD 08/02/2019
9E2E31 D8-CCD6-4BE5-8286-495AE63E926A 0027020044351425111880521271900