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HomeMy WebLinkAbout490185 FOOTHILLS TRUCKING LLC - INSURANCE CERTIFICATE (6)FOOTTRU-01 DONNA '4� �® CERTIFICATE OF LIABILITY INSURANCE DATE OIYYYY) ari/2ozo 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 ri tits to the certifCate holder in lieu.of such endorsements . PRODUCER c TACT -Donna Birleffi Renaissance Insurance Group- PO Box 478 Windsor, CO 80550 PHONE FAX A/C, No, Ext): (910) 545-3598 (A/C, No): AE'pakss, donna edninsur iice.com INSURERS AFFORDING COVERAGE NAIC # INSURERA:Secura Insurance Com anies INSURED INSURER B: Pinnacol Assurance 41190 INSURER C : Foothills Trucking LLC PO BOX 327 BelNue, CO 80612 -- INSURER D: INSURER E : INSURER F:. CnVFRet:FC ! CDTIMI�A TO'arl uaeee. 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 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 ADOL SUER POLICY NUMBER POLICY EFFIA POLICY EXP YYY OMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR X 3303498 5H/2020 5N/2021 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED $ 100,000 MED EXP (Any one erson $ 5,000 PERSONAL &ADV INJURY S 11000,000 AGGREGATE LIMIT APPLIES PER: POLICY ❑ JECT LOC GENERAL AGGREGATE S 2,000,000 GEN'L X PRODUCTS -COMPIOPAGG $ 2,000,000 $ OTHER: A AUTOMOBILE X LIABILITY ANY AUTO AUTOS SCHEDULED AUTOS ONLY AUTNNOSyyyyNNEEpp AUTOS ONLY AUOTO-ft& X X 3303499 5/1/2020 51V2027 C e arBIINED SINGLE LIMIT $ 1,000,000 BODILY INJURY Per arson $ BODILY INJURY Per accident) $ PeOramderyntDAMAGE $ $ UMBRELLA LWB OCCUR EACH OCCURRENCE S EXCESS LIAB CLAIMS -MADE AGGREGATE Is DIED RETENTION$ $ B woRKERRscOMPENSATON AND EMPLOYERS' LIABIUTY ANY PROPRIETOR/PARTNER/EXECUTIVE YIN (((j CER/ Vg ER EXCLUDED? ' tory m NH) It yes, da=be under DESCRIPTION OF OPERATIONS belay NIA X 151930 11/1/2019 11/1/2020 X PER 'OTH=- TAT T E.L. EACH ACCIDENT $ 100,000 E L. DISEASE - EA EMPLOYE $ 100,000 E.L. DISEASE - POLICY LIMIT $ 600,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space Is required) .. City of Fort Collins is listed as Additional insured for General Liability for ongoing operations per written contract Also listed as Additional Insured for Auto Liability. Blanket waiver of subrogation applies to Auto & Worker's Compensation policies. City of Fort Collins Purchasing Dept PO Box 680 Fort. 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 riahts reserved. The ACORD name and logo are registered marks of ACORD