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HomeMy WebLinkAbout102408 PIONEER PRESS OF GREELEY INC - INSURANCE CERTIFICATE (3)A� Ow CERTIFICATE OF LIABILITY INSURANCE 6A24i2o 5YY) 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 Ewing -Leavitt Insurance Agency 4025 St. Cloud Dr. Suite 100 Loveland CO 80538 CONTACT Karole Peters NAME: PHONE IAIC.No (970) 67 9 -7355 FA No: (866)237-2178 E"MAIL .karole-peters@leavitt.com ADRESS INSURERS AFFORDING COVERAGE NAIC # INSURERA:State Auto Insurance Companies 25127 INSURED Pioneer Press of Greeley, Inc. 2965 27th Ave. Greeley CO 80631 INSURERB:Pinnacol Assurance 41190 INSURERC: INSURERD: INSURER E INSURERF: COVERAGES CERTIFICATE NUMBER:15-16 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. LTR ILTR TYPE OF INSURANCE ADDL UBR POLICY NUMBER EFF MM DPOLID/YYYY MM/DDIYCY XP POLICY EYYY LIMITS GENERAL LIABILITY PBP 2626280 03 /1/2015 /l/2016 EACH OCCURRENCE $ 11000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO TED PREMISES Ea occurrence) $ 100 , 000 A I CLAIMS -MADE Fx_1 OCCUR MED EXP (Any one person) $ 10,000 PERSONAL & ADV INJURY $ 1,000,000 X Blanket Addl Insured X Blanket Waiver of Sub GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2,000,000 17 POLICY PRO X LOC $ AUTOMOBILE LIABILITY BAP 2352336 03 /1/2015 /1/2016 EOaaBINEDtSINGLELIMIT 1,000,000 X BODILY INJURY (Per person) $ A ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ X PROPERTY DAMAGE Per accident $ NON -OWNED HIRED AUTOS E AUTOS X UMBRELLA LAB X OCCUR PBP 2626280 03 /1/2015 /1/2016 OCCURRENCE $ 51000,000 [AGGREGATE $ 5,000,000 A EXCESS LIAB CLAIMS -MADE DED I X IRETENTION$ 0 1 $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE 4054974 /1/2015 /1/2016 X WCRSTAT OTH- ER E.L. EACH ACCIDENT $ 500,000 OFFICER/MEMBER EXCLUDED? N I A E.L. DISEASE - EA EMPLOYEE $ 500,000 (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below I I E.L. DISEASE - POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) City of Fort Collins is named Additional Insured on the General Liability and Auto Liability policies per written agreement. <haYll2Lh_\Ia:Lei 4#Ja: hr 9 1" 4 4 W.1 I Lei 9 City of Fort Collins Purchasing Division PO Box 580 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 le Peters/KAPETE ACORD 25 (2010/05) INS025 (201005).01 ©1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD