HomeMy WebLinkAboutED CARROLL MOTOR COMPANY INC - INSURANCE CERTIFICATEDATE (MM/DD/YYYY)
,A1CORD®
4CERTIFICATE OF GARAGE INSURANCE 1 01/18/2016
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 endorsements .
PRODUCER
CONTACT Sentry Customer Service
NAME:
NICOLE ELISE MARTI
FNCNNo, Ezt : 800-447-0633 FA/C, No): 888-533-7627
EMAIL ADDRESS: spbusinesroducts_ssdoiaseMry.com
INSURER(S) AFFORDING COVERAGE
NAIC #
INSURER A: SENTRY SELECT INSURANCE COMPANY
21180
INSURED
INSURER B :
ED CARROLL MOTOR COMPANY INC
INSURER C
3003 S COLLEGE AVE
INSURER D :
FT COLLINS, CO 60525
INSURER E :
INSURER F :
C-OVFRerF. PROD / CUSTOMER ID: CERTIFICATE #: 0002 REVISION #:
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
INSRD
SUBR
WVD
POLICY NUMBER
POLICY EFF
(MM/)D/YYYY)
POLICY EXP
(MM/DD/YYYY)
LIMITS
GARAGE LIABILITY
AUTO ONLY (Ea accident)
$ 500,000
A
ALL OWNED X� HIRED AUTOS
AUTOS ONLY
NON -OWNED AUTOS
USED IN GARAGE BUSINESS
Ix
25-57028-04
03/01/2016
03/01/2017
OTHER THAN
AUTO ONLY
EA ACCIDENT
$ 500,000
AGGREGATE
$ 2,500,000
GARAGE KEEPERS LIABILITY
CCTC P / LOC
$
LEGAL LIABILITY
PERILS ED LOC
$
COLLISION LOC
$
DIRECT BASIS
PRIMARY EXCESS
LOC
$
COMMERCIAL GENERAL LIABILITY
EACH OCCURRENCE
$
CLAIMS -MADE OCCUR
DAMAGE TO RENTED
PREMISES (Ea occurrence)
$
MED EXP (Any one person)
$
PERSONAL & ADV INJURY
$
GEN'L
AGGREGATE LIMIT APPLIES PER
GENERAL AGGREGATE
$
POLICY ❑ PRO- ❑ LOC
PRODUCTS -COMP/OP AGG
$
$
OTHER
X UMBRELLA LIAB
X
OCCUR
EACH OCCURRENCE
$ 5,000,000
A
X EXCESS LIAR
CLAIMS -MADE
25-57026-04
03/01/2016
03/01/2017
AGGREGATE
$15,000,000
DED RETENTION $
PRODUCTS - COMP/OP AGGOT
$ 15,000,000
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY
ER I
STATUTE ERH-
E.L. EACH ACCIDENT
$
ANY PROPRIETOR/PARTNER/EXECUTIVE
N / A
OFFICER/MEMBER EXCLUDED? Y / N
E.L. DISEASE - EA EMPLOYEE
$
(Mandatory in NH) ❑
0 yes, describe under
REMARKS below
E.L. DISEASE - POLICY LIMIT
$
REMARKS (ACORD 101, Additional Remarks Schedule, may be attached it more space is required)
Refer to attached
CERTIFICATE HOLDER CANCELLATION
CITY OF FORT COLLINS
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
RISK MANAGEMENT
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE
PO BOX 580
WITH THE POLICY PROVISIONS.
FORT COLLINS, CO 80522
AUTHORIZ SENTATIVE
ACORD 30 (2014/01)
2557028 0002
2010, 2014 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD 01/18/2016
1 00001 0000000280 16019 0 N 1FF927D1-1ED8-42F9-951D-3B9A3925E1FS
AGENCY CUSTOMER ID:
ACORO® LOG #:
ADDITIONAL REMARKS SCHEDULE Page of
AGENCY NAMEDINSURED
NICOLE ELISE MART
POLICY NUMBER
25-57028-04
CARRIER NAIC CODE
EFFECTIVE DATE: 03/012015
ADDITIONAL REMARKS
ACORD 101 (2008/01) OO 2008 ACORD CORPORATION. All rights reserved.
2557028 The ACORD name and logo are registered marks of ACORD 01 /18/2016