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HomeMy WebLinkAbout565243 CLEAR INTENTIONS LLC - INSURANCE CERTIFICATE (2)0 DATE IMMIDD/YYYY) CERTIFICATE OF LIABILITY INSURANCE srls.Izols 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 CONTACT NAME: Robin MUCke Security First Insurance Agency PHONE FAX 7851 S Elati St, Suite 100 IAJC. 303-730-2327 71(Arc, No):303-730-2930 Littleton CO 80120 ADDRESS: rmuckey@secudViirstia.com INSURED 1582d INSURERB:PInnaC0lAssurance 41190 Clear Intentions, LLC 5601 Downing St NsuRERc: Evanston Insurance Company 35378 Denver CO 80216 INSURER D : I INSURER E: COVERAGES CERTIFICATE NUMBER: 87479089 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. INSR LTR OF INSURANCE ADDLTYPE INSD S R POLICY NUMBER POLICY EFF MM DD/YYYY POLICY EXP MM DD/YY YY LIMITS X COMMERCIAL GENERAL LIABILITY Y Y CP3292100 08/252019 OW&2020 EACH OCCURRENCE S 1,DOO,ODO CLAIMS -MADE O OCCUR PREMISES Ea occurrence $ 300,000 MED EXP (Any one person) $10,000 PERSONAL S ADV INJURY $1,000,000 GENL AGGREGATE LIMB APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY a PRO- JECT � LOC PRODUCTS - COMP/OP AGG S2,000,000 S OTHER: I I AUTOMOBILE LIABILITY Y Y A3292101 08/252019 08252020 COMBINED SINGLE LIMIT _(Ea accident) $ 1000,000 _ ANY AUTO BODILY INJURY (Par person) $ ALL A'UTOS�ED XSCHEDAUTO$ULED BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per acridenI $ NON -OWNED X HIREDAUTOS x AUTOS $ x UMBRELLA LUAB X OCCUR Y Y CU329292102 XOBW8262319 08252019 08/252020 EACH OCCURRENCE $ 9,000,000 AGGREGATE $ 9,000.000 EXCESS LIAB CLAIMS -MADE DED I X I RETENTION$in we $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN Y 4177172 09/012019 09/012020 X PER H- TAT E E ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICERIMEMBER EXCLUDED? � NIA E.L. EACH ACCIDENT $1,000,000 (Mandatory in NH) E.L. DISEASE - EA EMPLOYE S 1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS balm E.L. DISEASE -POLICY LIMIT 1 $1.000 000 I IT I I DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached It more space Is required) City of Fort Collins is included as additional insured per the above policy conditions and endorsements in regard to the auto and general liability policies. City of Fort Collins 2115 N Mason St PO Box 580 Fort Collins CO 80522 Ae�aeL�a�navL.�cl 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 © 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD