HomeMy WebLinkAboutKYTO INC - INSURANCE CERTIFICATE (7)CUSTOMER NUMBER: 0006755901
AC"RV CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DDNYYY)
.. 05/14/18
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 PHARMACISTS MUTUAL INSURANCE COMPANY
808 HIGHWAY 18 WEST, PO BOX 370
_ALGONA, IA 50511-0370
INSURED
KYTO INC
MOBILITY AND MORE
493 DENVER AVE
LOVELAND CO 80537-5129
800-247-5930
INSURERA:Pharmacists Mutual Insurance
INSURER B:
INSURER C:
INSURER D:
INSURER E:
INSURER F:
COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
13714
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
INSD
SUBR
WVD
POLICY NUMBER
POLICY EFF
(MM/DD/YYYY)
POLICY EXP
(MM/DD/YYYY)
LIMITS
A
X
COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE FV-1 OCCUR
Y
BOP 0089544 12
Includes-
Health Care Services
Professional Liability
07/01/2018
07/01/2019
EACH OCCURRENCE
$ 1, 000, 000
DAMAGE TO RENTED
PREMISES (Ea occurrence)
$ 250, 000
MED EXP (Any one person)
$ 5, 000
PERSONAL 8 ADV INJURY
$ INCLUDED
-
GEN'L
AGGREGATE LIMIT APPLIES PER:
PRO-
POLICY JECT LOC
OTHER
GENERAL AGGREGATE
$ 2, 000, 000
PRODUCTS - COMP/OP AGG
$ 2,000,000
WATER LEGAL LIABILITY
$ 50, 000
•
AUTOMOBILE LIABILITY
ANY AUTO
AOX SCHEDULED
AUTOS AUTOS
X HIRED X NON -OWNED
AUTOS AUTOS
N
N
CAU 0089544 11
07/01/2018
07/01/2019
COMBINED SINGLE LIMIT
(Ea accident)
$ 1, 000, 000
BODILY INJURY
(Per person)
$
BODILY INJURY
(Per accident)
____________
$
PROPERTY DAMAGE
Per accident
$
A
X
UMBRELLA LIAB
EXCESS LIAB
X
OCCUR
CLAIMS -MADE
N
UCL 0089544 12
07/01/2018
07/01/2019
EACH OCCURRENCE
$ 1, 000, 000
AGGREGATE
$ 1, 000, 000
DED
X
RETENTION $ 10 , 0 0 0
$
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY
ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICER/MEMBER EXCLUDED? Y/N
(Mandatory In NH)
If yes, describe under ❑
DESCRIPTION OF OPERATIONS below
WA
PER OTH
STATUTE ER
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)
Loc:MOBILITY AND MORE
493 DENVER AVE
LOVELAND, CO 80537-5129
CERTIFICATE HOLDER CANCELLATION
CERT HOLDER/ADDITIONAL INSR ' D
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE
CITY OF FORT COLLINS
WITH THE POLICY PROVISIONS.
PO BOX 580
AUTHORIZED REPRESENTATIVE
FORT COLLINS CO 80522
GAIL T. WOLFE, CISR, API
01988-2014 ACORD CORPORATION. All rights reserved.
ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD