HomeMy WebLinkAboutSOILOGIC INC - INSURANCE CERTIFICATE (4)ACORN►® CERTIFICATE OF LIABILITY INSURANCE
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DATE (M
04; 091201YYY}
12018
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 Javier Perez
NAME:
Flood and Peterson
a/c No Ext (970) 356-0123 ,Ac No):(970) 330-1867
E-MAIL JPerez@FioodPeterson.com
ADDRESS:
PO Box 578
INSURER(S) AFFORDING COVERAGE
NAIC #
Greeley CO 80632
INSURER A: Plnnacol Assurance
41190
INSURED
INSURER B : Everest Indemnity Insurance Co.
10851
INSURER C :
S011oglc, Inc.
INSURER D :
3050 67th Avenue, Suite 200
INSURER E :
INSURER F
Greeley CO 80634
COVFRAr,FS CERTIFICATE NUMBER- CL184922796 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAYBE 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.
TR
TYPE OF INSURANCE
INSD
WVD
POLICY NUMBER
MMfDDYYYY
MM DD YYYY
LIMITS
COMMERCIAL GENERAL LIABILITY
EACH OCCURRENCE
$
DAMAGE TO RENTED
CLAIMS -MADE OCCUR
PREMISES Ea occurrence'
S
htED EXP (Any one person)
S
PERSONAL& ADV INJURY
S
GEMLAGGREGATE LIMIT APPLIES PER :
GENERAL AGGREGATE
S
POLICY ❑ PRO JECT ❑ LOC
PRODUCTS - COMP(OP AGG
S
S
OTHER.
AUTOMOBILE LIABILITY
COMBINED SINGLE LIMIT
Ea accident
S
BODILY INJURY (Per person)
S
ANY AUTO
OWNED SCHEDULED
AUTOS ONLY AUTOS
BODILY INJURY (Per accident)
$
PROPERTY DAMAGE
iPer accident
S
HIRED NON -OWNED
AUTOS ONLY AUTOS ONLY
S
UMBRELLA LIAB
OCCUR
EACH OCCURRENCE
$
AGGREGATE
S
EXCESS LIAB
CLAIMS -MADE
DED I I RETENTION $
S
A
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY Y r N
ANY PROPRIETOR/PARTNERrEXECUTIVE
OFFIC ERIMEMBER EXCLUDED?
(Mandatory In NH)
N/A
4093786
06/01/2017
06/01/2018
X STATUTE ERH
E.L. EACH ACCIDENT
1,000,000
S
E.L. DISEASE - EA EMPLOYEE
S 1,000,000
It yes, describe under
CESCRIPTION OF OPERATIONS below
E.L. DISEASE - POLICY LIMIT
$ ,600.000
B
Professional Liability
PLE000091-181
04/20/2018
04l2012019
Occurrence/Aggregate
$ 1l2,000.000
Deductible
$ 15,000
DESCRIPTION OF OPERATIONS 1 LOCATIONS I VEHICLES (ACORD 101. Additional Remarks Schedule, may be attached If more space Is required)
CCATIFICATC WC11 rIFR CANCFI I ATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
City of Fort Collins
ACCORDANCE WITH THE POLICY PROVISIONS.
281 N. College Ave.
AUTHORIZED REPRESENTATIVE
CO 80524
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Fort Collins
Y i
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