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HomeMy WebLinkAboutKEM COMMERCIAL LLC - INSURANCE CERTIFICATEACOR L7 CERTIFICATE OF LIABILITY INSURANCE KEMHO-2 OP ID: AL DATE (MM/DD/YYYY) 12/18/2015 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 CONTACT NAME: Michael J Schmitt CIC Rich & Cartmill Ins of CO PHONE FAX 970-356-8030 970-356-8032 of Colorado LLC (A1c No Ext� (A/C, No): 8213 W. 20th Street E-MAIL Greeley, CO 80634 Michael J Schmitt CIC __ INSURERS AFFORDING COVERAGE NAIC # _ INSURER A: First Mercury Insurance Co 10657 INSURED KEM Commercial LLC INSURER B :Liberty Mutual Insurance Co 23043 375 E. Horsetooth Rd #2-101 - -- _ Fort Collins, CO 80525 INSURER C : Pinnacol Assurance INSURER D : Harleysville Ins Co INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: 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 SUBR POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE Al OCCUR WA-CGL-0000060229-01 01/01/2016 01/01/2017 EACH OCCURRENCE $ 1,000,000 Mom€ TENTED PREMISES Ea occurrence $ 100,000 MED EXP (Any one person) $ _ 5,000 PERSONAL & ADV INJURY GENERAL AGGREGATE $ 1,000,000 $ 2,000,000 GENT AGGREGATE LIMIT APPLIES PER: 1-1 POLICY I - I jE O n L 0 C OTHER: PRODUCTS - COMP/OP AGG $ 2,000,000 lEmp Ben. $ 1,000,000 B AUTOMOBILE LIABILITY X ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS NON -OWNED HIRED AUTOS AUTOS ) I BAS55290257 01/01/2016 01/01/2017 COMBINED SINGLE LIMIT Ea accident __ $ 1000,00C _ r_ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident) _ $ $ UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DED 7 RETENTION $ $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Yr�/ —N OFFICER/MEMBER EXCLUDED? � (Mandatory in NH) If ye4 ,Iescrib—und- DESCRIPTION OF OPERATIONS oelow N / A _ 4179428 01/01/2016 01/01/2017 X PER OTH- STATUTE ER E.L. EACH ACCIDENT $ 500,000 — E.L. DISEASE - EA EMPLOYE -------- $ 500,000 E.L. DISL'ASE - POLICY LIMi7 $ 500,000 D Property Section CIM-16839X. j 01/01/2016 01/01/2017 i Trailer 22,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached it more space is required) CERTIFICATE HOLDER CANCELLATION CiT-FOR City of Fort Collins 281 N College Ave 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 Michael J Schmitt CIC © 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD