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HomeMy WebLinkAboutTRANSPRO BURGENERT TRUCKING - INSURANCE CERTIFICATEAcoRf> CERTIFICATE OF LIABILITY INSURANCE
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DATE (MM/DD/YYYY)
05/28/2018
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 have ADDITIONAL INSURED provisions or 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
CONTACT NAME: Heidi Mink
Flood and Peterson
PHONE Ezt ; (970) 356-0123 A/C. No : FAX (970) 330-1867
PO Box 578
ADDRESS: HMink®floodpeterson.com
INSURER(S) AFFORDING COVERAGE
NAIC Y
INSURER A: Great West Casualty Co.
11371
Greeley CO 80632
INSURED
INSURER B : Endurance American Specialty Insurance
41718
Transpro, Inc., DBA: Burgener Trucking Inc.
INSURER C: Pinnacol Assurance
41190
INSURER D :
DBA: Transpro Burgenert Trucking
INSURER E:
7301 Sw Frontage Road, Suite 3
INSURER F :
Fort Collins CO 80528
COVERAGES CERTIFICATE NUMBER: CL1852823477 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.
IPUL
LTR
TYPE OF INSURANCE
INSD
WVD
POLICY NUMBER
MM/DD/YYYY
MM/DD/YYYY
LIMITS
X
COMMERCIAL GENERAL LIABILITY
EACH OCCURRENCE
$ 1,000,000
CLAIMS -MADE � OCCUR
PREMISES Ea occurrence
$ 100,000
MED EXP (Any oneperson)
$ 5,000
PERSONAL& ADV INJURY
$ 1,000,000
A
Y
GWP61685J
06/01/2018
06/01/2019
GEN'L AGGREGATE LIMIT APPLIES PER:
GENERAL AGGREGATE
$ 2,000,000
X POLICY PRO LOC
JECT
PRODUCTS - COMP/OP AGG
$ 2,000,000
$
OTHER:
AUTOMOBILE
LIABILITY
COMBINED SINGLE LIMIT
Ea accident
$ 1,000,000
X
BODILY INJURY (Per person)
$
ANY AUTO
A
OWNED SCHEDULED
AUTOS ONLY AUTOS
Y
GWP61685J
06/01/2018
06/01/2019
BODILY INJURY (Per accident)
$
PROPERTY DAMAGE
Per accident
$
X
HIRED NON -OWNED
AUTOS ONLY X AUTOS ONLY
X
UMBRELLA LIAB
X
OCCUR
EACH OCCURRENCE
$ 5,000,000
AGGREGATE
$ 5,000,000
B
EXCESS LIAB
CLAIMS -MADE
EXT30000352601
06/01/2018
06/01/2019
DED I X1 RETENTION $ 10,000
$
C
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY Y / N
ANY PROPRIETOR/PARTNER/EXECUTIVE ❑
OFFICER/MEMBMBER EXCLUDED?
(Mandatory in NH)
N/A
4176705
06/01/2018
06/01/2019
PER OTH-
X STATUTE ER
E. L. EACH ACCIDENT
$ 1,000,000
E.L. DISEASE - EA EMPLOYEE
$ 1,000,000
If yes, describe under
DESCRIPTION OF OPERATIONS below
E.L. DISEASE - POLICY LIMIT
$ 1,000,000
Limit Per Unit
$100,000
A
Broad Form Cargo
GWP61685J
06/01/2018
06/01/2019
Retention
$25,000
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
Certificate holder is included as Additional Insured as required by written contract with respects to liability arising out of work performed by the named
insured.
CFRTIFIll Hni r1FR CANCFLLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
The City of Fort Collins
ACCORDANCE WITH THE POLICY PROVISIONS.
PO Box 580
AUTHORIZED REPRESENTATIVE
Fort Collins CO 80522
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