HomeMy WebLinkAbout243031 BC SERVICES INC - INSURANCE CERTIFICATE (2)ACCPRD® CERTIFICATE OF LIABILITY INSURANCE °A 11612020
311612
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.: It the certificate holder is an ADDITIONAL INSURED, the policy(les) 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
TrueNorth Companies, L.C.
275 S Main Street Suite 100
Longmont CO 80501
NAME:. RM_Lon rnont
PHoNF 303,7.76-5122 ___._..._ _ ac No:r303776,5495
M i 07
fAIC - ..
AD1)REss: cose icemana er uenortheo anies
INSURERS) AFFORDING COVERAGE' .
NAIC If
INSURER A: Pinnacol Assurance
41190
.INSURED BCSERVI.01
BC Services, Inc.
P O Box 1317
Longmont CO 80502
INSURERS: WestAmerican. Insurance .Com an
44393
tfisuRmc: Ohio Sec uri Insurance Com an
24082
INsURERD: The Ohio Casualty Insurance Co
24074
.
ASSURER E.:
INSURER F:
CPIVCGAr]FC r1FRTIFICAT5= NI IMRFR- 1QQnn7579Q REVISIUN NUMUEN:
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 BYPAID CLAIMS.
INSR
LTR
_ TYPEOFWSURANCE
AUUL
I
SU R
WVD
-
POUCYNUMBER
POLICY EFF
MWDp7Y`(
POLICY EXP
WDD/YY.
LIMITS
B
X
COMMERCIALGENERALLIABILITY
CLAIMS -MADE OCCUR
Y
BKS57687740
3124/2020
3/24/2021
EACHOCCURRENCE
_bAQWdM
$1.000.000
RENTED
PREMISES Ea occurrencol
$100,000
MED EXP (Any one person)
t 15.000
PERSONAL B ADV INJURY
$
GEN'L
AGGREGATE LIMIT APPLIES PER:
PRO 7 LOC
POLICY ❑ JECT
OTHER:
GENERAL AGGREGATE
$ 2,000,000
%(
PRODUCTS
$2;000,000
$
C
AUToMoaILEUABILITY
ANY. AUrO
'-- OWNED- SCHEDULED
AUTOS ONLY AUTOS'
X HIRED X NON -OWNED
AUTOSONLY __ AUTOS:ONLY
BAS57687740
3124/2020
3/24/2021
COMBINED SINGLE LIMIT
Ea accident
$1.000.000
BODILY INJURY (Per. person)
$
BODILY INJURY (Per accident)
S
PROPERTY
OPERT nDAMAGE -
$
_
$
D
X
UMBRELLA LIAR
EXCESS LIAB
X
OCCUR
CLAIMS -MADE
USCS7687740
3/24/2020
3124/2021
EACH OCCURRENCE
$ 5.000,000
AGGREGATE
$5,000,000
DED. I`...RETENTION $ in ann
$ ....
A
.WORKERS COMPENSATION
AND. EMPLOYERS' LIABILITY
ANYPROPRIETORMARTNER/EXECUTiVE Y❑
OFFICERlMEMBEREXCLUDED?
(Mandatory In NH)
yes,
DESCRI TIONund�r -
DESCRIPTION under RATIONS bebw
N I A
I
516892
7/1/2019
711/2020
X STATUTE ERH
E.L. EACH ACCIDENT
$100,000
E.L. DISEASE -.EA EMPLOYEE
$100,000If
EL.DISEASE-POLICY.LIMIT
$500,000
DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached U more space 1s required)
Certificate Holder is Additional Insured as their interest may appear in operations of the Named Insured on their behalf, as -required by written contract, with
respect to General Liability
SHOULD ANY OF THE ABOVE DESCRIBED POGCIES.BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
City of Fort Collins
PO Box 580
Fort Collins CO 60522
ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD
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