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HomeMy WebLinkAboutONSITE ELECTRONICS RECYCLING DBA IT REFRESH - INSURANCE CERTIFICATEONSIT-1 CIP ID: C AcoRO CERTIFICATE OF LIABILITY INSURANCE DAn (MM/DD/VYVV) �i ncv9a»ni a 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 endorsement/sl. PRODUCER 925-513-9080 DLS Insurance Services PO Box 505 Knightsen, CA 94548 CONTACT Diane Stockman NAME; _. PHONE 925-513-9080 A/C, No, Ext); a -MAID lane SInB.COm DDR ss: Diane Stockman INSURERIS) AFFORDII INSURER A: Arch Insurance Co. INSURER B : bNSURED nsite Electronics Recycling DBA: IT Refresh 1281 E. Ma nolia Unt D,Box 141 Fort Collin, CO 80524 INSURER C: INSURER D: 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._ INSR -LULC rypE OF INSURANCE ODL UBR POLICY NUMBER POLICY EFF MM1DDNYYY1 POLICY EXP (III LIMITS COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR EACH OCCURRENCE $ DAMAGE TO RENTEDPREMISES (ES S MED EXP (Any oneperson) $ PERSONAL it ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: POLICY jpa 7 LOC OTHER. GENERAL AGGREGATE $ PRODUCTS - COMP/OP AGG S A I AUTOMOBILE LIABILITY AUTO OWNAUTOS ONLY X SCHEDULED SSwULNEEDp AUTOS ONLY AUTOS ONLY x FBCAT0462000 09/21/2019 07/01/2020 COMBINED SINGLE LIMIT fEa accidentANY S 1,000,000 BODILY INJURY Per arson $ BODILY INJURY Per accadent $ PPe�aandent AMAGE $ S UMBRELLA LIAR OCCUR EXCESSUAS CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DED I I RETENTIONS WORKERS COMPENSATION AND EMPLOYERSLIABILITY YIN ANY PROPRIETORIPARTNERIEXECUTIVE Wp�.FICER/MEMBER EXCLUDED? )Mandatory in NH) If yes descnbe under DESCRIPTION OF OPERATIONS below NIA ISPTERTU OTH- E.L. EACH ACCIDENT E_._L_. DISEASE - EA EMPLOYE E.L. DISEASE -POLICY LIMIT DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES ACORD 101, Additional Remarks Schedule, may be attached If more space is required) Re: E-Waste Recycling Services City of Fort Collins named as additional insured with respect to Automobile Liability CITYFOR SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Fort Collins ACCORDANCE WITH THE POLICY PROVISIONS. PO Box 580 Fort Collins, CO 80522 AUTHORIZED REPRESENTATIVE ACORD 25 (2016103) © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD