HomeMy WebLinkAboutWALKER MANUFACTURING CO - INSURANCE CERTIFICATE (9),a�oRn® CERTIFICATE OF LIABILITY INSURANCE
DATE(MMIDDiYYYY)
03/26/2018
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 Kelly Beauvais, CIC. CISR
NAME:
Flood and Peterson
PHO{970} 266-7121 FAX (970) 330-1867
A/C N.E. Ext : C.No):
E-MAIL ADDRESS:kbeauvais@floodpeterson.com
PO Box 578
INSURERS) AFFORDING COVERAGE
NAIC #
INSURERA: Twin City Fire Insurance Company
29459
Greeley CO 80632
INSURED
INSURER B : Sentinel Insurance Company
11000
INSURER C : Pinnacol Assurance
41190
Walker Manufacturing Co.
INSURER D :
5925 East Harmony Road
INSURER E :
INSURER F :
Fort Collins CO 80528
COVERAGES CERTIFICATE NUMBER: Master - full cert 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.
INTR
R
TYPE OF INSURANCE
INSD
WVD
POLICY NUMBER
MM/DDY EFF
MMIDDN YY Y
LIMITS
X
COMMERCIAL GENERAL LIABILITY
EACH OCCURRENCE
5 1,000,000
CLAIMS -MADE X OCCUR
DAMAGE TO RENTED
PREM1IISES Ea occurrence
S 300 000
NIEDEXP(Any one personl
S Excluded
$100,000SIR
PERSONAL BADVINJURY
S 1,000,000
A
34ECSOF1729
09130/2017
09/30/2018
GEN'L AGGREGATE LIMIT APPLIES PER:
GENERAL AGGREGATE
5 2,000,000
X POLICY ❑ PRO ❑
JECT LOC
PRODUCTS - COMPIOP AGG
S 2,000,000
BLWOS
S
OTHER.
AUTOMOBILE LIABILITY
COMBINED SINGLE LIMIT
i Ea accident)
$ 1,000,000
BODILY INJURY (Per person)
S
ANY AUTO
B
OWNED SCHEDULED
AUTOS ONLY AUTOS
34UUNNJ0856
09/30/2017
09i30/2018
BODILY INJURY (Per accident)
S
PROPERTYDAMAGE
'Per accident
S
X HIRED HNON-OWNED
AUTOS ONLY AUTOS ONLY
Uninsured motorist
S 1,000,000
UMBRELLA LIAB
OCCUR
iZfz�,.(1_R'"E`N" i'
EACH OCCURRENCE
S
HCLAIMS-MADE
AGGREGATE
S
EXCESS LIAB
DED I I RETENTION $
5
C
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY Y I N
ANY PROPRIETOR;PARTNER/EXECUTIVE
OFFICERIMEMBEREXCLUDED?
(Mandatory In NH)
N/A
2270632
04/01/2018
04/01/2019
X STATUTE ERPER H
E.L. EACH ACCIDENT
$ 500,000
E.L. DISEASE - EA EMPLOYEE
S 500,000
If yes, describe under
DESCRIPTION OF OPERATIONS below
E.L. DISEASE - POLICY LIMIT
S 500,000
ET
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101. Additional Remarks Schedule, may be attached if more space Is required)
Certificate Holder is Additional Insured as their interests may appear regarding land leased at:
CFRTIFICATF HOI nFR CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
City Manager; City of Ft. Collins
ACCORDANCE WITH THE POLICY PROVISIONS.
300 LaPorte Ave
AUTHORIZED REPRESENTATIVE
Fort Collins CO 80521
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