HomeMy WebLinkAbout332904 JAG'S ENTERPRISES INC - INSURANCE CERTIFICATE (4)® ARV CERTIFICATEDATE (MMIDDr1'YYY) OF LIABILITY INSURANCE 5n82020
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 NAME:ONTACT . Katie Smothers
Commercial Risk Solutions PHONE
6600 E Hampden Ave Ste 200 • 303-996-780.1 ... A/C No): 303-757-7719
EMAIL _. :... .. ...
Denver CO 80224 D E33: ksmothers crsdenver.com
's Enterprises, Inc.
1 W 28th Street
eley CO 80634
oananlnse
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
ADVIL
INSD
5UBR
WVO
I
POLICY NUMBER
POLICY EFF
MM/DDNY.
POLICY EXP.
MAMDO/YY
um"
A
X I coMMERCIALGENERALLIABILITY
Y
MP19010205
1272020
1127I2021
EACH OCCURRENCE
$1.000,0007 ...
CLAIMS -MADE I OCCUR
DAMAGE TO HLNTLLI
PREMISES Me occurrence
$100,000
IMEDEXP (Any oneperson)
$5.000
PERSONAL SADV INJURY
$1.000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
GENERAL AGGREGATE
$ 2;00 ,000
POLICY F-V-1 jE&7 F7 LOC
PRODUCTS '-COMPiOPAGG
$2,000,000
$
OTHER:
A.
AUTO BIOBILELIABtiJTY
Y
MP19010205
11272020
12712021
COMaBINEDISIN) GLE LIMIT
$1,000.000
BODILY INJURY (Fier parson)
$
ANY AUTO
OWNED X HEDHED ULED
AUTOS ONLY
BODILY INJURY(Par acclden0'
$
(PeracdenDAMAGE
$
D
HIRED x- AUTOS ONLY x. AUTOS ONLYP
4X AUTOS ONLY
$
UMBRELLAUAB
OCCUR
EACHOCCURRENCE
Is
AGGREGATE
$
EXCESSUAB
CLAIMS -MADE
DED I I RETENTION $
$
B
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY Y / N
ANYPROPRIETOR/PARTNER/EXECUTIVE
OFFICERIMEMBEREXCLUDED?
NIA
4146867
6/12020
611/2021
X. PE STATUTE ERH
E.L. EACH ACCIDENT
$1,000,000
(Mandatory. In NMI
E.L. DISEASE - EA EMPLOYEE
$1,600,060
If ym, closcribo,undor
DESCRIPTION OF OPERATIONS bebw
E.L. DISEASE - POLICYLIMIT$
1.000,000
C
ILeased and Rented Equipment
SpecialFornVACV180% Coinsurance
ILM0707056
11272020
1/272021
Uma_
Deductble
50,000
1.000
DESCRIPTION OF OPERATIONS'/ LOCATIONS / VEHICLES (ACORD 101, Additional
City of fort Collins, its officers, agents and employees and Colorado
the General Liability and included as additional insured on the Auto
by Written contract. General.Liability coverage is primary and non-contributory.
Remarks Schedule,may be attached if more space la requtmd)
Department of Transportation are included as additional insured for ongoing operations on
Liability With respect to operations of the named insured for the certificate holder as required
All policy terms, conditions and exclusions apply.
City of Fort Collins
215,North Mason Street
Fort Collins CO 80524
SHOULD ANY OF THE ABOVE DESCRIBEDPOLICIES BE CANCELLED BEFORE
_
THE. EXPIRATION DATE. THEREOF, NOTICE WILL SE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
1
ACORD 25 (2016/03)
The ACORD name and logo are registered marks of ACORD
All
2' of 3 1737
NATIONAL AM
THIS ENDORSEMENT
RIGHT TO
(BLANKET I
This endorsement modifies insurance provic
BUSINESS AUTO COVERAGE FORM
MOTOR CARRIER COVERAGE FORM
INSURANCE COMPANY
THE POLICY. PLEASE READ IT CAREFULLY.
COVER FROM OTHERS
VER OF SUBROGATION)
under the following:
With respect to such insurance as is afforded by the policy for bodily injury liability and property damage liability arising
out of the ownership, maintenance or use of automobiles, we waivethe right to recovery we may have under the policy
against any person or entity for whom the insured is working or operating under written contract when such contract
requires a waiver of subrogation.
It is further agreed that the additional premium
by the company in the event of cancellation or
Additional Premium: $ _INCLUDED
All other terms and conditions ofthe policy
NAICO-31 (Ed. 6%2009) Contains copyrig
permission
the endorsement is a minimum chargeand shall be retained in full
nination of the endorsement of the policy.
n unchanged.
I of insurance Services Office, Inc., with its Page 1 of
Insurance services Office, Inc., 2008
T of 1737