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HomeMy WebLinkAboutMARTIN RAY LAUNDRY SYSTEMS INC - INSURANCE CERTIFICATEACOR" CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DDIVYYYj `,..� Fil/10/2015 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 PRODUCER The Wright Group Services 101 N Cascade Ave Colorado Springs CO 80903 INSURED MARTI-3 Martin Ray Laundry Systems Inc 2050 West 9th Ave Denver CO 80204-3846 Now . 719-354-4303 (AIC wj: 719-354-4112 ESS: esanchez@twgservices.com EMC PROP & CAS INS CO n0VFRAnFS rFRTIFIrATF NIIMRFR• 412164608 RFVISInN NIIMRFR- 25186 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 ADDLSUBR INSD WVD POLICY EFF POLICY NUMBER MMIDD/YYYY POLICY EXP MMIDDIYY LIMITS A X COMMERCIAL GENERAL LIABILITY - —1 CLAIMS -MADE X OCCUR Y 5D34421 8/1/2015 8/1/2016 EACH OCCURRENCE $1,000,000 PREMISES Ea occurrence -- $100,000 MED EXP (Any one person) $10,000 PERSONAL & ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PET LOC OTHER: GENERAL AGGREGATE $2,000,000 PRODUCTS - COMP/OP AGG $2,000,000 Emp Bert $1,000,000 AUTOMOBILE LIABILITY ANY AUTO AOSUTODULED AUTOS A HIRED AUTOS NON -OWNED AUTOS Eaaccident $ BODILY INJURY (Per person) $ BODILYINJURY (Per accident) S S _-- Per accident) UMBRELLA LIAB EXCESS UAB OCCUR CLAIMS -MADE EACH OCCURRENCE S S $ AGGREGATE DED � RETENTIONS WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ OFFICER/MEMBER EXCLUDED? (Mandatory in NH) It yes, describe under DESCRIPTION OF OPERATIONS below NIA OT - STATUTE ER $ S S E.L.. EACH ACCIDENT E.L. DISEASE - EA EMPLOYEE E.L. DISEASE - POLICY LIMIT DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) The City, its officers, agents and employees shall be named as additional insureds on the General Liability insurance policy for any claims arising out of work performed under this Agreement. CERTIFICATE HOLDER CANCELLATION 30 City of Ft Collins, Purchasing Dept PO 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. AUTH�ORI,�EDD REPRESENTATIVE © 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD ACORD". CERTIFICATE OF LIABILITY INSURANCE DATE(/ 11/10/2l10/2015 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. PRODUCER Pinnacol Assurance inna 7501 E Lowry Blvd Denver, CO 80230-7006 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A Plnnaaol Assurance 41190 Martin Ray Laundry Systems Inc 2050 W 9th Avenue Denver, CO 80204 INSURERS INSURER C INSURER D' INSURER E- COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDNG ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMMENT 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 ADDI POLICY EFFECTIVE POLICY EXPIRATION LTR INSRD TYPE OF INSURANCE POLICY NUMBER DATE(MMIDD(YYYY) DATE(MMIDD/YYYY) LIMITS GENERAL LIABILITY EACH OCCURRENCE DAMAGE TO RENTED COMMERCIAL GENERAL LIABILITY CLAIMS MADE OCCUR PREMISES MED EXP(Ariy one person PERSONAL & ADV INJURY GEN'L AGGREGATE LIMIT APPLIERS PER: GENERAL AGGREGATE PRODUCTS - COMPIOP AGG POLICY PROJECT LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT ANY AUTO (Ea Aaident) BODILY INJURY ALL OWNED AUTOS SCHEDULED AUTOS (Per person) BODILY INJURY HIRED AUTOS NON -OWNED AUTOS (Per accident) PROPERTY DAMAGE (Per accident) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT OTHER THAN EA ACC ANY AUTO - AUTO ONLY: AG EXCESSIUMBRELLA LIABILITY EACH OCCURRENCE AGGREGATE OCCUR CLAIMS MADE DEDUCTIBLE RETENTION $ WORKERS COMPENSATION AND WC STATU- OTHER A EMPLOYER'S LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE 4112861 04/Ot/20t rJ TORY LIMITS E.L EACH ACCIDENT $1,000,000 OFFICER/MEMBER EXCLUDED? • - E.LDISEASE- EAEMPLOYEE $1,000,000 If yes, please describe under SPECIAL PROVISIONS below E.L DISEASE- POLICY LIMIT 1 000 000 OTHER DESCRIPTION OF OPERATIONSILOCATIONSIVEHICLESIEXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION 1655958 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Ft. Collins Attn: Purchasing Dept P.O. BOX 580 Fort Collins, CO 80522 THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO NOTIFY 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO NOTIFY SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE Aundria Martin ACORD 25(2001108) Underwriter ACORD CORPORATION 1988 CERTIFICATE HOLDER COPY City of Ft. Collins Attn: Purchasing Dept P.O. Box 580 Fort Collins, CO 80522 IMPORTANT If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). 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). DISCLAIMER The Certificate of Insurance on the reverse side of this form does not constitute a contract between the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon.