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HomeMy WebLinkAbout108976 L & M ENTERPRISES INC - INSURANCE CERTIFICATE (4)ACORO0 CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDDIYYYY) F12/28/2015 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 Ewing -Leavitt Insurance Agency 4025 St. Cloud Dr. Suite 100 Loveland CO 80538 CONTACT NAME, Renee McReynolds PHONrE EX (970) 679-7344 FAX No: (866)425.6180 E-MAILs:renee-mcreynolds@leavitt.com ADDRES INSURERS AFFORDING COVERAGE NAIC # INSURERA:Cincinnati Insurance Co 10677 INSURED L & M Enterprises, Inc. 735 E Highway 56 P O Box W Berthoud CO 80513 INSURERB:Pinnacol Assurance 41190 INSURERC: INSURERD: INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER:16-17 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 J=SUBR POLICY NUMBER MM/DDPOLICYIYYYYI, (MM/DDIYYYYI LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A CLAIMS -MADE X� OCCUR DAMAGE TO TED PREMISES (Ea occurrence) $ 500,000 X MED EXP (Any one person) $ 10,000 Blanket WOS ENP0224898 1/l/2016 1/1/2017 X Blanket Addl Insureds PERSONAL BADVINJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 Additional Insured form PRO - POLICY a JECTPRO- ❑ LOC includes ongoing and PRODUCTS - COMP/OP AGG $ 2,000,000 $ OTHER: completed operations AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ 1,000,000 X BODILY INJURY (Per person) $ A ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS ENP0224898 1/1/2016 1/l/2017 BODILY INJURY (Per accident) $ X PROPERTY DAMAGE Per accident $ NON -OWNED HIRED AUTOS X AUTOS X $ Blkt WOS X Blkt Addl Insureds X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 4,000,000 AGGREGATE $ 4,000,000 A EXCESS LIAB CLAIMS -MADE DIED I X I RETENTION$ 0 $ ENP0224898 1/l/2016 1/1/2017 B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER EXECUTIVE OFFICER/MEMBER EXCLUDED? � (Mandatory in NH) NIA A incl Blanket Waiver of Subrogation endt 4188429 1/1/2016 l/l/2017 X PER OTH- STATUTE ER E.L. EACH ACCIDENT _ $ 1,000,000 E.L. DISEASE - EA EMPLOYE — — $ 1 000 000 , If yes, describe under —_�, DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 1,000,000 A Contractors' Equipment ENP0224898 1/l/2016 1/1/2017 Leased/Rented Equipment $85,000 Installation Fltr $150,000limit $1000 deduct DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) re: 8016 SH392 & I-25 Community ID Signs Certificate holder is named additional insured as respects both general and auto liability policies. CERTIFICATE HOLDER CANCELLATION City of Fort Collins P O Box 580 Fort 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 R McReynolds/RESTED ACORD 25 (2014/01) I NS025 (201401) ©1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD