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HomeMy WebLinkAboutWILLIAM D HILLEN - INSURANCE CERTIFICATEACORO® CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DDIYYYY) 03/16/2018 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 Moody Insurance Agency, Inc. 8055 East Tufts Avenue Suite 1000 Denver CO 80237 CONTACT NAME: Debbie Smith, CIC PHONE (303) 824-6600 FAAic No : (303) 370-0118 A C No Et]: E-MAIL debbie.smith@moodyins.com ADDRESS: INSURERS) AFFORDING COVERAGE NAIC # INSURER A : Plnnacol Assurance 41190 INSURED William D Hillen, A Corp. 7600 Dahlia Street Commerce City CO 80022 INSURER B : INSURER C : INSURER D : INSURER E : INSURER F : Cf1VFRAnFR CERTIFICATE NUMBER: 18/19 WC 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. INSR LTR TYPE OF INSURANCE AIJIJL1bUbK INSD WVD POLICY NUMBER POLIC Y EFF MMIDD/YYYY POLICY EXP MM/DD/YYYY LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ DAMAGE TO RENTED CLAIMS -MADE F7 OCCUR PREMISES Ea occurrence S MED EXP (Any one person) $ PERSONAL & ADV INJURY S N GEN'L AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE S PRODUCTS - COMP/OP AGG S POLICY EJECT LOC S OTHER AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ BODILY INJURY (Per person) $ ANY AUTO BODILY INJURY (Per accident) S OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED AUTOS ONLY AUTOS ONLY N PROPERTY DAMAGE Per accident $ s UMBRELLA LIAB OCCUR EACH OCCURRENCE S Ll AGGREGATE $ EXCESS LIAR CLAIMS -MADE DED I RETENTION $ S A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ OFFICER/MEMBER EXCLUDED? (Mandatory in NH) NIA 3091443 04/01/2018 04/01/2019 PER OTH- STATUTE ER E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE - POLICY LIMIT $ 1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) e'COTICIP`ATC U^1 ncD rANCF1 I ATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN The City of Fort Collins Purchasing Department ACCORDANCE WITH THE POLICY PROVISIONS. PO Box 580 AUTHORIZED REPRESENTATIVE Fort Collins CO 80522 /� � a . srr�k% © 1988-2015 ACORD CORPORATION. All rights reserveo. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD