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HomeMy WebLinkAboutLEI COMPANIES INC - INSURANCE CERTIFICATE (3)F....
ACC>Ra
l..J CERTIFICATE OF LIABILITY INSURANCE
DATE 01/2(MMMI15
l0/0l/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 1-303-534-4567
INA, Inc. - Colorado Division
CONTACT
NAME:
PHONE FAX
IAIC. No):
E-MAIL
ADDRESS. denaccounttechsAimacorp.com
1705 17th Street
INSURE S AFFORDING COVERAGE
NAIC S
Suite 100
INSURER A:RMFIELD INS CO
24112
Denver, CO 80202
INSURED
INSURER 8: PINK&COL ASSUR
41190
INSURER CIMDIAN BARBOR INS CO (ET. N—ironmsatal. 3
84)40
LEI Companies, Inc.
INSURER D:
2017 Curtis St
INSURER E .
INSURERF:
Denver, CO 80205
rAVFRArFS CFRTIFICATF NIIMRFR- 45164320 REVISION NIIMRFRZ
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. _ - -_
SISR
LTR
TYPE OF INSURANCE
ADDL
SUBR
POLICY NUMBER
POLICY EFF
ID Y
POLICY EXP
MWDD
UYRS
A
X
COMMERCIAL GENERAL LIABILITY
TRA7910440
10/01/15
10/01/16
EACH OCCURRENCE
$ 1,000,000
CLAIMS -MADE EXI OCCUR
DGE TO RENTED
PRAEM SES Ea occu ence
$ 500,000
X
MED EXP (Any one person)
S 10,000
PD DED: $500
PERSONAL & ADV INJURY
$ 1,000,000
_
AGGREGATE LIMIT APPLIES PER:
GENERAL AGGREGATE
$ 2,000,000
GENL
POLICY L-X] ECT D LOC
PRODUCTS -COMP/OPAGG
$ 2.000,000
$
OTHER:
A
AUTOMOBILE
LIABILITY
TRA7910440
10/01/15
10/01/16
COMBINED SINGLE LIMIT
Ea accident
=
1,000,000
BODILY INJURY (Per peron)
$-_
Z
ANY AUTO
BODILY INJURY (Per accdent)
$
ALL OWNED SCHEDULED
AUTOS AUTOS
PROPERTY DAMAGE
Per accident
$
z
X NON -OWNED
HIRED AUTOS AUTOS
-
$
A
X
UMBRELLA I"
Y
OCCUR
TRI1,7910440
10/01/15
10/01/16
EACH OCCURRENCE
$ 9,000,000
AGGREGATE
$ 91000,000
EXCESS LIAR
CLAIMS -MADE
DIED I % I RETENTION $ 0
$
B
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY YIN
ANY PROPRIETORIPARTNER/EXECUTWE --I
OFFICERIMEMBER EXCLUDED?
(Mandatory In NH)
N / A
4062205
10/01/15
10/01/16
z 3 ATUT ER
E.L. EACH ACCIDENT
$ 1,000,000
E.L. DISEASE - EA EMPLOYEE
$ 1,000,000
If yes descnbs under
DESCRIPTION OF OPERATIONS below
E.L. DISEASE - POLICY LIMIT
$ 1,000,000
A
Leased & Rented Equipment
TRA7910440
10/01/15
10/01/16
Limit $100,000
Deductible $ 500
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may he attach" If mom space Is required)
L,tK 111-1L.A 1 t MULUtK %,AM%,r-LLA I IUM
rcityL
icense IIME-1227.
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
Of Ft. Collins THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
P.O. Box 580 AUTHORIZED REPRESENTATIVE /.wFt. CollinIsUSA ((((, CO 80522 /
ACORD 25 (2014101)
njones2014
45164320
©1988-2014 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD
00
O
N
P526W1281N@
DATE
SUPPLEMENT TO CERTIFICATE OF INSURANCE
NAME OF INSURED:
Additional Description of Operations/Remarks from Page 1:
Additional Information:
Installation Floater Coverage: Policy #TRA7910440
Effective Dates: 10/01/2015-10/01/2016 Insurer A: See Above
$300,000 Any One Location; $9,000,000 Per Disaster;
$300,000 Transit; $300,000 Temporary Location; $500 Deductible; SPC Form
Pollution/Professional Combined: Policy #PEC0046718
Effective Dates: 10/01/2015-10/01/2016 Insurer C: See Above
$2,000,000 Each Occurrence; $2,000,000 Aggreagate; $10,000 Deductible
N
SUPP (05/04)