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HomeMy WebLinkAbout103009 PORTER INDUSTRIES - INSURANCE CERTIFICATE (6)Client#: 14405 PORIN2 ACORD_ CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 06/19/2015 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 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 Flood 8r Peterson Ins., Inc. P. O. Box 578 Greeley, CO 80632 970 356-0123 NT CT NAME: Kelly Beauvais PHONE 970 266-7121 F°/X 970 506-6845 A!C No Ext : A/C, No E-MAIL ADDRESS: KBeauvais floodP eterson.com INSURER(S) AFFORDING COVERAGE NAIC # INSURERA: Travelers Insurance Company INSURED Porter Industries, LLC dba Porter Industries;Maid Clean 129 South Madison Ave Unit 2 INSURERB: Plnnacol Assurance INSURER C INSURER D : Loveland, CO 80537 INSURER E INSURER F 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 CONTRACTOR 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. R LT LTR TYPE OF INSURANCE ADDLSUBR INSR WVD VD I POLICY NUMBER POLICY EFF /Y MMIDDYYY POLICY EXP MM/DDIYYYY LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE 5XI OCCUR P6602B955731TIA15 2/05/2015 02/05/2016 EACHOCCURRENCE$1000000 PREMISES (ERENTED r nce) $100,000 MED EXP (Any one person) $5,000 PERSONAL & ADV INJURY $1 ,000,000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: x POLICY PRO LOC JECT PRODUCTS - COMP/OP AGG $ 2,000,000 $ A AUTOMOBILE LIABILITY X ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS X HIRED AUTOS X NON -OWNED AUTOS P8102B955731 COF15 2/05/2015 02/05/201 ED accidentSINGLE LIMIT $1 000 000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ $ A X UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE PSMCUP2B955731TIL1 405/2015 02/05/2016 EACH OCCURRENCE s5,000,000 AGGREGATE $S 00O 000 DED I I RETENTION $ $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y 1 N OFFICER/MEMBER EXCLUDED? ❑ (Mandatory i,-. NH) If yes, describe under DESCRIPTION OF OPERATIONS below N I A 4183855 6/16/2015 07/01/201 X TW STAID- OTH- s ER E.L. EACH ACCIDENT $1 00O 000 E.L. DISEASE - EA EMPLOYEE $1 000,000 E.L. DISEASE - POLICY LIMIT $1 ,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) RE: 6120 Carpet Maintenance City of Fort Collins is listed as an Additional Insured as their interest may appear as respects General Liability. [113;4112 0111;4 ; L911111ML4 V City of Fort Collins Purchasing Department PO Box 580 Fort Collins, CO 80524 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 (2010/05) 1 Of 1 #S978992/M978938 ©1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD KLB Client#: 14405 PORIN2 ACORD,. CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 1 06/19/2015 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 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 iCONTACT I NAME: Kelly Beauvais Flood 8: Peterson Ins., Inc. P. O. Box 578 Greeley, CO 80632 970 356-0123 I PHONE 970 266-7121 FAX AI No Ext : A/C, No): 970 506-6845 ADDRESS: KBeauvais@floodpeterson.com INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: Travelers Insurance Company INSURED Porter Industries, LLC dba Porter Industries;Maid Clean 129 South Madison Ave Unit 2 INSURER B : Plnnacol Assurance INSURER C INSURER D Loveland, CO 80537 INSURER E INSURER F 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 CONTRACTOR 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 ADDL INSR SUBR' WVD I POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MMIDDIYYYY LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE � OCCUR P6602B955731TIA15 2/05/2015 02/05/201 EACHOCCURRENCE$1 000000 PREMISES Ea RENTED $100,000 MED EXP (Any one person) $ 5,000 PERSONAL B ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER X POLICY PROECT LOC PRODUCTS - COMP/OP AGG $ 2,000,000 $ A AUTOMOBILE LIABILITY X ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS NON -OWNED X HIRED AUTOS X AUTOS P810213955731 COF15 2/05/2015 02/05/201 MBIND Ea acccid.n,SINGLE LIMIT $1 ,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ A X UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE PSMCUP213955731TIL1 1 2/05/2015 02/05/2016 EACH OCCURRENCE S5,000,000 AGGREGATE s5,000,000 DED 7 RETENTION $ $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE� OFFICERIMEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N / A 4183855 6/1612015 07/01/201 )( WC STATU- OTH- E.L. EACH ACCIDENT $1 OOO O00 E.L. DISEASE - EA EMPLOYEE $1 ,000,000 E.L. DISEASE -POLICY LIMIT $1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) RE: Transfort; Transit South; Transit North City of Fort Collins is listed as an Additional Insured as their interest may appear as respects General Liability. L,Af41,r LLA I Ivry City of Fort Collins SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE y THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN PO Box 580 ACCORDANCE WITH THE POLICY PROVISIONS. Fort Collins, CO 80524 AUTHORIZED REPRESENTATIVE ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) 1 of 1 The ACORD name and logo are registered marks of ACORD #S978981/M978938 KLB Client#: 14405 PORIN2 ACORD- CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDD/YYYY) 1 06/19/2015 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 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 ICOITACT NAME: Kelly Beauvais Flood & Peterson Ins., Inc. P. O. Box 578 Greeley, CO 80632 970 356-0123 PHONE 970 266-7121 FAX AIC No. xt : A/C, No): 970 506-6845 E-MAIL ADDRESS: P KBeauvais ood eterson.com INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: Travelers Insurance Company INSURED INSURER B : Pinnacol Assurance Porter Industries, LLC INSURER C : dba Porter Industries;Maid Clean INSURER D 129 South Madison Ave Unit 2 INSURER E Loveland, CO 80537 . INSURER F 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 CONTRACTOR 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 ADDL INSR SUBR' WVD I POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MMIDD/YYYY LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE I OCCUR P6602B955731TIA15 2/05/2015 02/05/2016 EACH OCCURRENCE $1 000 000 Ep PRAMAG ETO R ENTE ance $1 OO,000 MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER X POLICY PRO LOC JECT PRODUCTS-COMP/OP AGG $2,000,000 _ $ A AUTOMOBILE LIABILITY'�I X ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS X HIRED AUTOS X AUTOSWNED P8102B955731 COF15 2/05/2015 02/05/201 COMBINED SINGLE LIMIT Ea accident $ 1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ I AMAGE PerOa cPER d $ A X UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE PSMCUP2B955731TIL1 2/05/2015 02/05/2016 EACH OCCURRENCE $5000000 AGGREGATE $5 00O 000 DIED I I RETENTION $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE � OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N / A 4183855 6/16/2015 07/01/201 X WC STATU- OTH- IER TORY LIMITS$ E.L. EACH ACCIDENT $1 00O 000 E.L. DISEASE - EA EMPLOYEE $1 ,000,000 E.L. DISEASE - POLICY LIMIT $1 ,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) City of Fort Collins is listed as an Additional Insured as their interest may appear as respects General Liability. City of Fort Collins Custodial Services PO BOX 580 Fort Collins, CO 80524 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 ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) 1 of 1 The ACORD name and logo are registered marks of ACORD #S978986/M978938 KLB