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HomeMy WebLinkAbout129729 EXODUS MOVING & STORAGE INC - INSURANCE CERTIFICATE (14)EXODUI-1 OP ID: DA .44cOR0' CERTIFICATE OF LIABILITY INSURANCE `� D09/0212ATE Y01 9/02/25 5 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 Brown &Brown Inc 4532 Boardwalk Dr, Suite 200 Fort Collins, CO 80525 NADMEACT Diana Vigil PHONE g70-482-7747 IX Ne : 970-484-4165 A c No Ext ADDRIESS: dvigil@bbcolorado.com Kitren E. Siwek, CPA INSURERS AFFORDING COVERAGE NAIC p INSURER A:Vanllner Insurance Company 21172 INSURED Exodus Moving and Storage Inc INSURER B: Pinnacol Assurance Company 41190 1730 E Prospect Rd Ste 102 Fort Collins, CO 80525 INSURERC: INSURER D : 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 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 LTR rypE OF INSURANCE ADDL UB POLICY NUMBER POLICY EFF MMIDD/YYYY POLICY EXP MMIDDIYYYY LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 CLAIMS -MADE a OCCUR X PKV0000214 03 09/01/2015 09/01/2016 DAMAGE TRENTED PREMISES Ea occurrence 1OO OO , $ MED EXP (Any one person) $ 10,00 PERSONAL B ADV INJURY $ 1,000,00 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,00 POLICY PRO JECT ❑ LOC PRODUCTS - COMP/OP AGG $ 2,000,00 $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ 1,000,00 BODILY INJURY (Per person) $ A ANY AUTO X MRV4272804 01 09/01/2015 09/01/2016 ALLOWNED X ASCHEDULED AUTOS UTOS BODILY INJURY (Per accident) $ PROPERTYDAMAGE Peraccitlant $ NON -OWNED HIRED AUTOS AUTOS X Ded $1,000 X Ded$1,000 $ X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 5,000,00 AGGREGATE $ 5,000,00 A EXCESS LIAB CLAIMS -MADE X UMV4272804 01 09/01/2015 09/01/2016 DED I X I RETENTION$ 10,000 $ B WORKERS COMPENSATION EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y / N OFFICERIMEMBER EXCLUDED? (Mandatory In NH) NIA 4O82S58 09/01/2015 09/01/2016 X PTA STATUTE ER E.L. EACH ACCIDENT $ 1,000,00 E.L. DISEASE - EA EMPLOYEE £ 1,000,00 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 1,000,00 A Hired Auto Phy Dmg MRV4272804 01 09/01/2015 1 09/01/2016 PD Limit 100,00 A Cargo CGV4272804 01 09/01/2015 09/01/2016 Cargo 300,00 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required) City of Fort Collins and its elected & appointed officials & employees are included as additional insureds as their interests may appear on the general liability & auto liability if required by written contract. Waiver of subrogation applies on the workers compensation if required by written contract per form 359b CFRTIFICATF HOI nFR CANCELLATION FORTCOL SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of Fort Collins Purchasing P.O. Box 580 AUTHORIZED REPRESENTATIVE Fort Collins, CO 80522t V �ytir ACORD 25 (2014101) ©1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD