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HomeMy WebLinkAbout167490 PEAK AUDIO VISUAL DBA CCS PRESENTATION SYST - INSURANCE CERTIFICATE (4)OP ID: SR AcoRO CERTIFICATE OF LIABILITY INSURANCE DATE/18/2 Y016 01 18/26 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 Carver and Associates 7710 Ralston Road Arvada, CO 80002 Don W Carver CONTACT NAME: PHONE IFAX A/c No EXc : A/C No): E-MAIL ADDRESS: PRODUCER CC PR-2 CUSTOMER ID #: INSURERS AFFORDING COVERAGE NAIC # INSURED Peak Audio Visual dba INSURER A: Travelers Indemnity of America 36161 CCS Presentation Systems 700 West Mississippi Ave., A-6 Denver, CO 80223 INSURER 8: INSURERC: INSURER D INSURER E : INSURER F : ?In"=DAn=C C ERTtt=!!'eTI= kit IMRF4• REVIS'•.f)N NUMBER: vTHIS 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 ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR TYPE OF INSURANCE POLICY NUMBER MM/DD/YYYY MM/DD/YYYY GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 A X COMMERCIAL GENERAL LIABILITY 680654OB135 02/18/2016 02/18/2017 PREMISES Ea occurrence $ 300,00 MED EXP (Any one person) $ 5,00 CLAIMS -MADE 1:X1 OCCUR PERSONAL & ADV INJURY $ 1,000,00 GENERAL AGGREGATE $ 2r000e00 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2,000,00 $ POLICY X PRO LOC ECT A AUTOMOBILE LIABILITY ANY AUTO 680654OB135 02/18/2016 02/18/2017 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,00 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ ALL OWNED AUTOS PROPERTY DAMAGE (PERACCIDENT) $ SCHEDULED AUTOS HIRED AUTOS X X $ NON -OWNED AUTOS UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 4,000,00 AGGREGATE $ 4,000,00 A EXCESS LIAB CLAIMS -MADE CUP0576T235 02/18/2016 02/18/2017 DEDUCTIBLE $ $ RETENTION WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y WC STATU- OTH- T RY (MIT E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ OFFICER/MEMBER EXCLUDED? F (Mandatory in NH) N / A E L DISEASE - POLICY LIMIT $ If yes, describe under DESCRIPTION OF OPERATIONS below A Business Owners 680654OB135 02/18/2016 12118/2017 (Property 117,08 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) Certificate holder, its officers, agents and employees are additional insured if required by written contract CERTIFICA City of Fort Collins Purchasing and Risk Management P. O. Box 580 Fort Collins, CO 80522 FORTC-6 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 © 1988-2009 ACORD GORPUKA I ION. All rights reservea. ACORD 25 (2009/09) The ACORD name and logo are registered marks of ACORD