HomeMy WebLinkAboutCOKAN ENTERPRISES INC - INSURANCE CERTIFICATE (5)-441111111
Ac<> "0 CERTIFICATE OF LIABILITY INSURANCE
ATE
Drrz6�zoz is
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(les) 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
Insurance Planning Inc.
3006 Broadway Avenue
P. O. BOX 100
Bays KS 67601
NAM: CONTACT Kathy Casper
PNONE (785)62S-S6O5FAX
No:(785)625-8388
AIL
DDDDRESS:caspka@insurance-planning. cam
INSUR 9 AFFORDING COVERAGE
NAIC0
INSURER A. -National American Insurance CO
INSURED
Cogan Enterprises Inc.
13831 County Line Road 22
Fort Lupton CO 80621
INSURERB:United Fire 6 Casualty13021
INSURER C:
INSURERD:
INSURER E:
INSURER F:
COVERAGES CERTIFICATE NUMBER:15/16 Certificates 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 INSURANCEADOL
POLICY NUMBER
POLICY EFF
MMIDDIYYYY)
POLICY EXP
(MMfDDNYYYI
LIMITS
R
COMMERCIAL GENERAL LIABILITY
EACH OCCURRENCE
$ 2,000,000
A
CLAIMS -MADE F—xl OCCUR
PREMISES Ea occurrence
$ 100,000
MED EXP(Any one Person)
$ 5,000
MP12690005
6/27/2015
6/27/2016
PERSONAL B ADV INJURY
$ 2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
GENERAL AGGREGATE
$ 2,000,000
R POLICY ❑ JEST LOC
PRODUCTS - COMPIOP ADD
s 2,000,000
$
OTHER:
AUTOMOBILE
LIABILITY
Ea eBIINNEeDI SINGLE LIMIT
It 1,000,000
BODILY INJURY (Per person)
s
B
ANY AUTO
ALL OWNED SCHEDULED
AUTOS AUTOS
60416298
6/27/2015
6/27/2016
JX
BODILY INJURY(Per accident
)HIRED
s
AUTOS R NON -OWNED
AUTOS
PROPERTY DAMAGE
Per accident
$
$
UMBRELLA LIAB
EACH OCCURRENCE
$
HOCCUR
AGGREGATE
$
EXCESS LIAB
CLAIMS -MADE
DED RETENTION
$
WORKERS COMPENSATION
PER OTH-
ANDEMPLOYERS'LIABILITY YIN ._
ANY PROPRIETORIPARTNERIEXECUTNE
OFFICERIMEMBER EXCLUDED?
NIA
_ __ _.__
__ _
_
STATUTE ER_
E.L. EACH ACCIDENT
s
E.L. DISEASE - EA EMPLOYE
$
(Mandatory in NH)
If yes describe under
DESCRIPTION OF OPERATIONS below
E.L. DISEASE - POLICY LIMIT I
s
B
Leased/Rented Equipment
60416298
6/27/2015
6/27/2016
Lund $100,000
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached N more space Is required)
Additional Insured in favor of the City of Fort Collins in regards to General Liability as their interest
may appear.
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
City of Fort Collins THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
PO BOX 580 ACCORDANCE WITH THE POLICY PROVISIONS.
Fort Collins, CO 80526
AUTHORIZED REPRESENTATIVE
Kathy Kathy Casper/CASPKA —7-, 7 (2�
01988-2014 ACORD CORPORATION. All rights reserved.
ACORD 26 (2014/01) The ACORD name and logo are registered marks of ACORD
INS025 r?rttwt t