HomeMy WebLinkAboutPIPERS GREASE MONKEY INC - INSURANCE CERTIFICATE (4)Additional Insured Copy
FEDERATED INSURANCE COMPANIES
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED ENDORSEMENT
This endorsement modifies the insurance provided under the following:
BUSINESSOWNERS LIABILITY COVERAGE FORM
SCHEDULE
Name of Person or Organization:
CITY OF FORT COLLINS
215 N MASON ST
FORT COLLINS CO 80524
Relationship to the Named Insured:
"Any coverage provided by this endorsement applies only to service
work on certholder vehicles at locations the certholder owns, leases,
operates, or controls"
A. The following is added to Paragraph C. Who is
an Insured:
4. Any person or organization shown in the
Schedule is also an insured, but only with
respect to "bodily injury" or "property
damage" liability arising out of your ongoing
operations performed for that insured or
premises owned by or rented to you.
B. This insurance does not apply to "bodily injury"
or "property damage" liability arising out of the
sole negligence of the additional insured named
above.
C. The following exclusion is added to Paragraph B.
Exclusions:
This insurance does not apply to "bodily injury"
or "property damage" occurring after:
Insured:
PIPERS GREASE MONKEY INC
6318 CATTAIL CT
FORT COLLINS CO 80525
(1) All work including materials, parts or
equipment furnished in connection with
such work, on the project (other than
service, maintenance or repairs) to be
performed by or on behalf of the
additional insured(s) at the site of the
covered operations has been completed, -
or
(2) That portion of "your work' out of which
the injury or damage arises has been
put to its intended use by any person or
organization other than another
contractor or subcontractor engaged in
performing operations for a principal as
a part of the same project.
Place of Issue:
FEDERATED MUTUAL INSURANCE COMPANY
Home Office
121 East Park Square
Owatonna, MN 55060
(507) 455-5200
Includes copyrighted material of Insurance Services Office, Inc_ with its permission.
BP-F-239 (09-08) Policy Number: 9190781 Transaction Effective Date: 08-06-2018