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Home My WebLink About103009 PORTER INDUSTRIES - INSURANCE CERTIFICATE (10)A� RbP CERTIFICATE OF LIABILITY INSURANCE io E(MWDD 5Y) 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 Flood and Peterson PO Box 578 Greeley CO 80632 CONTACT WhitneyMorgan, CLCS, CISR NAME: y g PHONE (970) 356-0123 A/tFA-C N (970)330-1867 E-MAIL WMorganQfloodpeterson.com A DRESS INSURERS AFFORDING COVERAGE NAIC # INSURERA:Cincinnati Indemnity Co 23280 INSURED Porter Industries, LLC 129 South Madison Ave Unit 2 Loveland CO 80537 INSURERB:Pinnacol Assurance 41190 INSURER C: INSURER D : INSURER E : INSURERF: COVERAGES CERTIFICATE NUMBER:CL1510106131 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 TYPE OF INSURANCE ADDL SUER POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DD/YYYV LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTE' PREMISES Eaoccu ante $ 100,000 A CLAIMS -MADE 7OCCUR EPP0347942 8/15/2015 8 /15/2 016 MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $ 1,000,000 X Blanket AI/WOS/Primary GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2,000,000 X POLICY PRO IE LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident 1,00 000 X BODILY INJURY (Per person) $ A ANY AUTO BODILY INJURY (Per $ ALL OWNED CHEDULED PP0347942 8/15/2015 8/15/2016 AUTOS AUTOS accident) PROPERTY DAMAGE $ NON -OWNED HIRED AUTOSPS AUTOS Per accident Medical payments $ 5,000 X UMBRELLA LIAB HCLAIMS-MADE OCCUR EACH OCCURRENCE $ 5,000,000 AGGREGATE $ 5,000,000 A EXCESS LIAB DED I I RETENTION$ $ EPP0347942 B/15/2015 8/15/2016 B WORKERS COMPENSATION x WC STATU- OTH- AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? ❑ (Mandatory in NH) N / A 4183855 6/16/2015 7 /1/2016 E.L. DISEASE - EA EMPLOYEE, $ 1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) Certificate holder is included as Additional Insured regarding Auto and General Liability. 1IrtH I II-It.:A I t nULUtH City of Fort Collins 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 ACORD 25 (2010/05) INS025 (201005).01 Morgan, CLCS, CISR/ © 1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD ACoRbr CERTIFICATE OF LIABILITY INSURANCE io/a/zoi5 Y) 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 Flood and Peterson PO Box 578 Greeley CO 80632 CONTACT g NAME: Whitney Morgan, CLCS, CISR PHONE (970) 356-0123 FAX N ; (970)330-1867 E-MAIL,ADDRESS:WMorganQfloodpeterson.com INSURERS AFFORDING COVERAGE NAIC # INSURERA:Cincinnati Indemnity Co 23280 INSURED Porter Industries, LLC 129 South Madison Ave Unit 2 Loveland CO 80537 INSURERB:Pinnacol Assurance 41190 INSURER C: INSURERD: INSURER E : INSURER F: COVERAGES CERTIFICATE NUMBER:CL1510106131 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 TYPE OF INSURANCE ADDL INSR SUBR WVD POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DD/YYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 GENERAL LIABILITY DAMACOMMERCIAL PREM T NTED PREMISES Ea occurrence $ 100, 000 A CLAIMS -MADE OCCUR EPP0347942 8/15/2015 8/15/2016 MED EXP (Any one person) $ 5,000 PERSONAL& ADV INJURY $ 1,000,000 X Blanket AI/WOS/Primary GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2,000,000 X POLICY PRO LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident 1,000,000 X BODILY INJURY (Per person) $ A ANY AUTO BODILY INJURY $ ALL OWNED SCHEDULED EPP0347942 8/15/2015 8/15/2016 AUTOS AUTOS (Per accident) PROPERTY DAMAGE Per accident $ NON -OWNED HIRED AUTOS AUTOS Medical payments $ 5,000 X UMBRELLA LIAB HCLAIMS-MADE OCCUR EACH OCCURRENCE $ 5,000,000 AGGREGATE $ 51000,000 A EXCESS LIAB DED I I RETENTION$ $ EPP0347942 8/15/2015 8/15/2016 B WORKERS COMPENSATION X WC STATU- OTH- AND EMPLOYERS' LIABILITY Y / N E.L. EACH ACCIDENT $ 1,000,000 ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? ❑ (Mandatory in NH) N/A 4183855 6/16/2015 7 /1/2016 E.L. DISEASE - EA EMPLOYE $ 1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE- POLICY LIMIT 1 $ 1 000 000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) GtFI I IrIL:A 1 t r1ULLJtht City of Fort Collins Utilities Department 700 Wood Street Bldg A 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 W Morgan, CLCS, CISR1 02o ga - ACORD 25 (2010/05) INS025 (201005) 01 © 1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD