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HomeMy WebLinkAboutCOKAN ENTERPRISES INC - INSURANCE CERTIFICATE (10)ACC)R" ® DATE (MWDD/YYYY) �� CERTIFICATE OF LIABILITY INSURANCE F6/30/2017 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 Kathy Casper Insurance Planning Inc. 3006 Broadway Avenue P. O. Box 100 Hays INSURED KS 67601 NAME: PHONN (785) 625-5605 FAXNO: (785)625-8388 (AlIQE-MAIL Cab ka@insurance- lannin ADDRESS_ P P gcom I INSURER(S) AFFORDING COVERAGE I NAIC B I CoKan Enterprises Inc. INSURERC: 13831 County Line Road 22 INSURERD: INSURER E : _ Fort Lupton CO 80621 INSURERF: COVERAGES CFRTIFICATF NIIMRFRI7/18 Certificates RFVlglnN NIIMRFR- 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 WVD POLICY NUMBER POLICY EFF POLICY EXP MM NYYY MWDD(YYYY) LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 2,000,000 A CLAIMS -MADE IXOCCUR DAMAGE TO RENTED PREMISES (Ea occurrence $ 100,000 MED EXP (Any one person) $ 5,000 MP12690205 6/27/2017 6/27/2018 PERSONAL & ADV INJURY $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY � JET 171 LOC PRODUCTS - COMP/OP AGG $ 2,000,000 $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ 11000,000 X BODILY INJURY (Per person) $ B ANY AUTO ALL OWNED SCHEDULED AUUTOSS AUTOS 60416298 6/27/2017 6/27/2018 BODILY INJURY (Per accident) $ X PROPER PPE - DAMAGE $ X NON -OWNED HIRED AUTOS AUTOS _ UMBRELLA LIAR OCCUR EACH OCCURRENCE $ PCED AGGREGATE $ XCESS LIAR CLAIMS -MADE I I RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N PER TH- STATUTE I ER ANY PROPRIETOR/PARTNERIEXECUTIVE E.L. EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? N / A E.L. DISEASE - EA EMPLOYE -- $ (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT -- $ B Leased/Rented Equipment 60416298 6/27/2017 6/27/2018ILimit $100,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Additional Insured in favor of the City of Fort Collins in regards to General Liability as their interest may appear. CERTIFICATE HOLDER CANCELLATION (970)224-6134 City of Fort Collins PO Box 580 Fort Collins, CO 80526 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 Kathy Casper/CASPKA }' ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD INS025 (201401)