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HomeMy WebLinkAboutWILLMARK ENTERPRISES INC - INSURANCE CERTIFICATE (3)AC R" CERTIFICATE OF LIABILITY INSURANCE F DATE Y) 6/2g�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 I CONTACT Brandie Z c k Moody Insurance Agency, Inc. 8055 East Tufts Avenue Suite 1000 Denver CO 80237 INSURED Willmark Enterprises Inc P O Box 120 e General Insurance Corporation120095 Firestone CO 80520 I INSURER F: COVERAGES CERTIFICATF NIIMRFR•15-16 Master No Forms RFVICIr1N rdI 111AR1=0- 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. I�TR TYPE OF INSURANCE A L SUBR POLICY NUMBER MM/OD/YYYY MM/DDNYYY LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR r EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED PREMISES Ea occurrence $ 100, 000 MED EXP (Any oneperson) $ 5,000 CLP3606789 7/1/2015 7/1/2016 PERSONAL & ADV INJURY $ 11000,000 GENT X AGGREGATE LIMIT APPLIES PER: POLICY PRO- ❑ JECT LOC GENERAL AGGREGATE $ 2,000,000 PRODUCTS-COMP/OPAGG $ 2,000,000 $ OTHER AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 X BODILY INJURY (Per person) $ $ A ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS CAP3606790 7/1/2015 7/1/2016 P BODILY INJURY (Per accident ( ) HIRED AUTOS NON -OWNED AUTOS PROPERTY DAMAGE Per accident $ Medical payments $ 5,000 X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 1,000,000 AGGREGATE $ 1,000,000 A EXCESS LIAB CLAIMS -MADE DED I X I RETENTION$ 10,000 $ CUP2806284 7/1/2015 7/1/2016 B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / NI ANY PROPRIETOFVPARTNER/EXECUTIVE ❑ OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N/A 4059734 7/1/2015 7/1/2016 X 7 PER OTH- 5TATLITEER E.L. EACH ACCIDENT $ 11000,000 E.L. DISEASE- EA EMPLOYE $ 1, 000, 000 E.L. DISEASE - POLICY LIMIT I - $ 1,000,000 A Contractors Equipment CLP3606789 7/1/2015 7/1/2016 Limit 88,600 Deductible 1,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) t,crl I Irit.A I c ntJLUrri UANL:tLLA I IUN City of Fort Collins 300 LaPorte Ave Fort Collins, CO 80521 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 Zuckerman, CRIS/BRA ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD INS025 (201401)