Loading...
HomeMy WebLinkAboutGEMINI FIRE PROTECTION INC - INSURANCE CERTIFICATE (3)OP ID: SS '4` oRo CERTIFICATE OF LIABILITY INSURANCE DATE (30/20Y5 07/0/2015 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 endorsements . PRODUCER Phone: 720-962-0930 NAME: Shaleen Martin Six & Geving Insurance Inc #4 Fax: 720-962-0942 PHONE 303-653-0023 FAX, No : 720-962-0942 Denver Branch lac. No. E,,t):AJC 225 Union Blvd. #575 AIL ADDRESS: smartin@six-geving.com Lakewood, CO 80228 PRODUCER Nancy McGrath CUSTOMER ID#: GEMIN-2 INSURERS AFFORDING COVERAGE _ NNC # INSURED Gemini Fire Protection, Inc INSURERA:Everest Indemnity___ P.O. Box 202 INSURER B : Acuity 14184 Elizabeth, CO 80107 INSURER C : Pinnacol Assurance 41190 INSURER D : INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: REVISION NLIMRFR- 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. INSR TYPE OF INSURANCE ADDL.SUBR POLICY EFF POLICY EXP LIMITS LTR POLICY NUMBER MM/DD MM/DD/YYYY GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE X ! OCCUR X 51GL005754-151 08/01/2015'108/0112016 AMAGET RENTED PREMISES Ea occurrence $ 50,00 MED EXP (Any one person) $ 5,00 PERSONAL R ADV INJURY $ 1,000,00 _ GENERAL AGGREGATE $ 2,000,00 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS -COMP/OP AGG $ 2,000,00 X POLICY PRO LOC $ B AUTOMOBILE LIABILITY X ANY AUTO 25731 08/01/2015 08/01/2016 COMBINED SINGLE LIMIT (Ea accident) $ 1,0�0,�0 BODILY INJURY (Per person) $ ALL OWNED AUTOS - BODILY INJURY (Per accident) - $ SCHEDULED AUTOS HIRED AUTOS $ PROPERTY DAMAGE (Per accident) $ NON -OWNED AUTOS $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DEDUCTIBLE $ $ RETENTION $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE YI❑YN OFFICER/MEMBER EXCLUDED? (Mandatory in NH) NIA 4059669 08/01/2015 08/01/2016 X WC STATU- I OTH- TORY LIMITSFIR E.L. EACH ACCIDENT $ 500,00 $ 500,00 E.L. DISEASE - EA EMPLOYEE If yes. describe under DESCRIPTION OF OPERATIONS below $ 500,00 E.L. DISEASE - POLICY LIMIT B Rented Equip Z25731 08/01/2015 08/01/2016 Per Item 50,00 A Professional Liab 51GL005754-151 08/01/2015 08/01/2016 IPROF Incl in GIL DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) RE: Contractors License. City of Fort Collins is named as additional insured as respects General Liability if required by written contract. I-IL:A I t MULUtK CTYFT-1 City of Fort Collins P.O. 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 © 1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009/09) The ACORD name and logo are registered marks of ACORD