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103484 RNR SUPPLY INC - INSURANCE CERTIFICATE (2)
Z_%4L_ 9—IFKLJ CERTIFICATE OF LIABILITY INSURANCE DA04/10/2018Yl 04110/2018 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 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 Phone: 970-223-1804 CONTACT Front Range Insurance Group NAME: PHONE FA% - -- 2002 Caribou Drive, Ste. 101 Fax: lac. No. Extl: ac No Fort Collins, CO 80525 E-MAIL AssuredPartners Colorado ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # _ INSURERA:ACUIty INSURED RNR Supply Inc. INSURER B : Pinnacol Assurance 41190 RNR Service Doug Curtis INSURERC: 2329 E. Mulberry St. INSURERD: Ft. Collins, CO 80524 INSURERE: INSURER F : CnVFRAr,FS rFRTIFICATF IJI IMRFR• oMAne,nu ui u�ore. 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 INSURANCEADDL POLICY NUMBER POLICY EFF MM/DD/YYYYI POLICY E%P (MM/DDfYYYYI -- LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE X OCCUR X X90051 03/01/2018 03/01/2019 EACH OCCURRENCE $ 1,000,000 PREMISES Ea occurrence $ 100,00 MED EXP (Any one person) $ 10,00 PERSONAL & ADV INJURY $ 1,000,00 GENERAL AGGREGATE $ 2,000,00 GE N'L AGGREGATE LIMIT APPLIES PER: X POLICY PRO LOC PRODUCTS - COMP/OP AGG $ 2,000,00 $ A AUTOMOBILE LABILITY ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS NON -OWNED HIRED AUTOS Ix AUTOS X90051 03/01/2018 03/01/2019 CEO aBINEDtSINGLE LIMIT $ 1,000,00 X BODILY INJURY (Per person) $ BODILY INJURY Per accident) ( ) $ X PROPERTY DAMAGE Per accident $ $ A X UMBRELLA LAB EXCESS LAB X OCCUR CLAIMS -MADE 1 X90051 03MI12018 03/01/2019 EACH OCCURRENCE $ 1,000,000 AGGREGATE $ 1,000,000 $ DED X RETENTION $ 10,000 B WORKERS AND EMPLO ERS' COMPENSATION ABILIITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? ❑ (Mandatoryin NH) If yes, describe under DESCRIPTION OF OPERATIONS below NIA 4134992 03/01/2018 03/01/2019 X DRY LIMITWC OTR- I E.L. EACH ACCIDENT $ 100,00 E.L. DISEASE - EA EMPLOYEE $ 100,00 E.L. DISEASE - POLICY LIMIT $ 500,00 A Property X90051 03/01/2018 03/01/2019 BPP 500,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) 970-224-6134 UANk r-l-LA 1IVry CITYOFF 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 Fort Collins, CO 80524 AUTHORIZED REPRESENTATIVE © 1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD