Loading...
HomeMy WebLinkAbout168310 SCHRADER OIL CO - INSURANCE CERTIFICATE (10)/1 SCHRA-4 OP ID: GRTI DA08/0712019TE Y) o8ro7/zo1 s ACORN CERTIFICATE OF LIABILITY INSURANCE 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 endorsements . PRODUCER 719-593.5814 Legacy Insurance Network, LLC 13540 Northgate Estates Dr#210 C NTACT Tim Gries PHONE 719-5935814 FAX 719-388-2075 (A/C, No, Ext): A/C, No): Colorado Springs, CO 80921 Brian Gries Miss.tim@legacyinsurancebroker.com INSURERS AFFORDING COVERAGE NAIC p INSURER A: PInnacol Assurance 41190 N URE c r er Oil Company 2tt lleg@ Ave ort ol�ins, C0 80524 INSURER B : INSURER C : INSURER D : INSURER E INSURER F : rnVFRAr:FC rFRTIFIrATF NIIMPI RFVI-R[nN NIIMRFR- 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 TYPE OF INSURANCE DDL SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR EACH OCCURRENCE $ DAMAGE TO RENTED PREMISES (Ea occ:urrenw) $ MED EXP (Any oneperson) PERSONAL B ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: POLICY D JECpT LOC OTHER GENERAL AGGREGATE PRODUCTS - COMPIOP AGG $ AUTOMOBILE LIABILITY ANY AUTO OWNED SCHEOULED AURTEO�S ONLY AU�TNOS p AUTOS ONLY AUTOS ONLY COMBINED SINGLE LIMIT BODILY INJURY Per arson $ BODILY INJURY Per accitlent $ POa xR,deot AMAGE $ UMBRELLA LIAR EXCESS LUIB OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DED RETENTIONS A WORKERS COMPENSATION AND EMPLOYERS•LIABILITY YIN ANY PROPRIETORIPARTNEWEXECUTIVE FFICERAIEMBER EXCLUDED? FNI I and. my In NH) If es. describe under D RIPTI N OF OPERATIONS below NIA 180714 10/01/2019 10/01/2020 X PER OTH- LE E.L. EACH ACCIDENT 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1'000'000 E.L. DISEASE -POLICY LIMIT 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached If more space Is required) CITYY-2 City of Ft Collins Po Box 580 Ft 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