HomeMy WebLinkAbout111347 HAMILTON LAUNDRY COMPANY - INSURANCE CERTIFICATE (7)DATE (MM/DD/YYYY)
AC oR" CERTIFICATE OF LIABILITY INSURANCE
2/24/2016
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 CONTACT
NAME:
Hays Companies PHONE Ext) A/C No
(816) 474-3535 F'� (8816) 842-5795
1200 Main Street, Suite #2310 ADDRESS:
INSURERISI AFFORDING COVERAGE NAIC #
Kansas City MO 64105
INSURED Hamilton Laundry Company
Faultless Laundry Company, Inc
1480 E. 61st Street
INSURER A :Old
INSURER C :
Co.
INSURER E :
Denver CO 80216 INSURER F •
I+CI IT I^" = \II IRAMI=O.U7 cr.1hT.1Wr•1TTT. 1 1 All 7 R9=VISIr1N KII IMRFR-
25674
vTHIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOTV14THSTANDING 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 L UBR POLICY EFF POLICY EXP LIMITS
LTR TYPE OF INSURANCE POLICY NUMBER MM/DD/YYYY MM/DD/YYYY
A
X COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE x OCCUR
EACH OCCURRENCE
$ 1,000,000
PREMISES Ea occurrence)
$ 500,000
MED EXP (Any one person)
$ 10,000
X
MWZY306277
3/1/2016
3/1/2017
PERSONAL & ADV INJURY
$ 1,000,000
GENERAL AGGREGATE
$ 2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
PRODUCTS - COMP/OPAGG
$ 2,000,000
X PRO ❑ LOC
POLICY ❑ JECT
OTHER:
AUTOMOBILE LIABILITY
CoMrINED
Ea accident) IN L LIMI
$ 1,000,000
BODILY INJURY (Per person)
$
A
X ANY AUTO
ALL OWNED SCHEDULED
AUTOS AUTOS
HIRED AUTOS NON-OWNED
X X
MWTB 306276
3/1/2016
3/1/2017
BODILY INJURY (Per accident)
$
PROPERTY DAMAGE
Per accident
$
Com /Coll Ded
$ 1,000
X
UMBRELLA LIAB
X
OCCUR
EACH OCCURRENCE
$ 1,000,000
AGGREGATE
$ 1 000 000
B
EXCESS LIAR
CLAIMS -MADE
DED 1 X 1 RETENTION$ 10,000
$
ZUP-14P64533-16-NF
3/1/2016
3/1/2017
WORKERS COMPENSATION
OTH-
X I STATUTE I I ER
E.L. EACH ACCIDENT
$ 1,000,000
AND EMPLOYERS' LIABILITY Y / N
ANY PROPRIETOR/PARTNER/EXECUTIVE
E.L.DISEASE - EA EMPLOYE
$ 1,000,000
A
OFFICEER EXCLUDED? ❑
in
(Mandatory in NH)
N / A
MWC 306275 00
3/1/2016
3/1/2017
E.L: DI£EASE-POJCY LlMtr -..a.
1 -OD-D 000
If es, describe under
D�SCRSF i0i� OF v'PERATiGiJa below
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space Is required)
As respects General Liability, City of Fort Collins is included as Additional Insured as required by
written contract.
GtK I IrICA It nUL_UtK
City of Fort Collins
PO Box 580
Ft. 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
s Hays / LROBB
U IUU11-ZU14 AL.VKU I.VKYVKA I IVR. All fIgIILS ICSCI VCU.
ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD
INS025 (201401)