HomeMy WebLinkAboutAIR X-TREME LLC - INSURANCE CERTIFICATEACORD. CERTIFICATE OF LIABILITY INSURANCE
DATE(MM/OD/1'YYY)
03/04/2016
PRODUCER
Pinnacol Assurance
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY
7501 E Lowry Blvd
Denver, CO 80230-7006
AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE
COVERAGE AFFORDED BY THE POLICIES BELOW.
INSURERS AFFORDING COVERAGE NAIC#
INSURED
Air X-Treme LLC
INSURER A: Pinnacol Assurance
41190
INSURER B:
2013 1st Avenue Unit F
Greeley, CO 80631
INSURER D:
INSURER D:
INSURER E:
COVERAGES
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDNG
ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMMENT 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
ADUL
POLICY EFFECTIVE
POLICY EXPIRATION
LTR
INSRD
TYPE OF INSURANCE
POLICY NUMBER
DATE(MMIDD/YYYY)
DATE(MM/DD/YYYY)
LIMITS
GENERAL LIABILITY
EACH OCCURRENCE
DAMAGE TO RENTED
COMMERCIAL GENERAL LIABILITY
CLAIMS MADE OCCUR
PREMISES
NED EX Anyone person
PERSONAL B ADV INJURY
GEN'L AGGREGATE LIMIT APPLIERS PER:
GENERAL AGGREGATE
PRODUCTS - COMPIOP AGO
POLICY PROJECT LOG
AUTOMOBILE LIABILITY
COMBINED SINGLE LIMIT
ANY AUTO
(Ea Accident)
BODILY INJURY
ALL OWNED AUTOS
SCHEDULED AUTOS
(Per person)
BODILY INJURY
HIRED AUTOS
NON -OWNED AUTOS
(Per accident)
PROPERTY DAMAGE
(Per aocident)
GARAGE LIABILITY
AUTO ONLY - EAACCIDENT
OTHER THAN EA ACC
ANY AUTO
AUTO ONLY: AG
EXCESSWMBRELLA LIABILITY
EACH OCCURRENCE
AGGREGATE
OCCUR CLAIMS MADE
DEDUCTIBLE
RETENTION $
WORKERS COMPENSATION AND
WC STATU- OTHER
A
EMPLOYER'S LIABILITY
ANY PROPRIETOR/PARTNER/EXECUTIVE
4180335
02/01/2016
02/01/2017
TORY LIMITS
E.L EACH ACCIDENT
$100,000
OFFICERIMEMBER EXCLUDED?
EL DISEASE - EA EMPLOYEE
$100,000
If yes, pleasedescribeunder SPECIAL PROVISIONS below
E.L DISEASE -POLICY LIMIT
500 IM)
OTHER
DESCRIPTION OF OPERATIONSILOCATIONSIVEHICLESIEXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS
CERTIFICATE HOLDER
CANCELLATION
1684052
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
City of Fort Collins
215 North Mason Street
THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO
NOTIFY 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO
2nd Floor
Fort Collins, CO 80522
THE LEFT, BUT FAILURE TO NOTIFY SUCH NOTICE SHALL IMPOSE NO
OBLIGATION OR LIABILITY OF ANY KIND UPON THE COMPANY, ITS AGENTS OR
REPRESENTATIVES.
AUTHORIZED REPRESENTATIVE
Jamie Pallas
ACORD 25(2001/08)
Underwriter ACORD CORPORATION 1988