HomeMy WebLinkAbout166269 GARNEY HOLDING CO - INSURANCE CERTIFICATE (15)o® CERTIFICATE OF LIABILITY INSURANCE
DATE (MMiDD,'YYYY)
9/2912019
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(s)•
PRODUCER
Arthur J Gallagher & Co.
1255 Battery Street #450
San Francisco CA 94111
INSURED
Garney Holding Company
1333 NVV Vivion Road
Kansas City, MO 64118
Insurance Brokers of CA.
COVERAGES CERTIFICATE NUMBER_ 122R075803 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.
� DCSDBR. __..—_T-__ _. - _FOCI YEFF Y .__.—_—__ _-.__.___—
LTR TYPE OF INSURANCE POLICYNUMBER MIND LIMITS
A
X
COMMERCIAL GENERAL LiniurrY
F__1
CLAIMS -MADE I OCCUR
Y
Y
T82641426942729
10/1/2019
10/12020
EACH OCCURRENCE
$2,000,000
DAMAGE TO RENTE
PREMISES (Ee occurrence)
MED EXP (Any one arson)
$300,000
S 10,000
PERSONAL $ ADV INJURY
$ 2,000.000
GEN'LAGGREGATE LIMIT � APPLIES PER:
POLICY JECT F7 LOC
OTHER:
GENERAL AGGREGATE
$4,000,000
PRODUCTS - COMP/OP AGO
$4,000,000
$
A
AUTOMOBILEUABILITY
X ANY AUTO
OWNED SCHEDULED
AUTOS ONLY AUTOS
X AUTOS ONLY X AUTO ONLY
Y
Y
AS2641426942719
10/1/2019
10/1/2020
OMBINED SINGLE LIMIT
ac ant
S2,OD0,000
BODILY INJURY (Per person)
$
BODILY INJURY (Per accident)
$
(Per aE d1g0_ GE
$
$
B
X UMBRELLA LIAB
EXCESS LIAB
X
OCCUR
CLAIMS -MADE
ZUP 14S7845219NF
10/1/2019
10/1/2020
EACH OCCURRENCE
$15,000,000
AGGREGATE
$15.000,000
DEG RETENTION$
$
A WORKERS COMPENSATION
A AND EMPLOYERS' LIABILITY Y / N
ANYPROPRIETORPARTNER/EXECUTIVE
OFFICER'MEMBEREXCLUDED? ❑
(Mandatory In NH)
It yes, describe under
DESCRIPTION OF OPERATIONS below
NIA
Y
WA264Da26942739
WC26414377239D9
10/12019
10/12019
1D/1/2020
10l12020
X A TE I I R
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 VEHICLES (ACORD 101. Additional Remarks Schedule, may be attached If more space is required)
City of Fort Collins P.O. Box 580
215 North Mason Street, 2nd Floor
Fort Collins CO 80522
USA
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
01988-2015 ACORD CORPORATION. All rights reserved.
ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD
2'pr17 1078