HomeMy WebLinkAbout507959 FLAGGERS INC - INSURANCE CERTIFICATE (13)�.�••, FLAGINC-01 PWEEKS
'4C'ORL7 CERTIFICATE OF LIABILITY INSURANCE FDATE (MM/DD YYYY)
03/14/2018
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 CoMEACT Paula Weeks
Forsberg Engerman Co PHONE FAX, No :(303) 762-1733
3575 S Sherman St (A/C, No, Ext): (303) 762-1717
Englewood, CO 80113 E- pRE . paula@forsberg-engerman.com
INSURER A:Burlington Insurance Co 23620
INSURED INSURER B:Cincinnati Insurance Companies 10677
Flaggers Inc INSURER c : Evanston Insurance Company 35378
420 E 58th Ave #116 INSURER D :
Denver, CO 80216
INSURER E
INSURER F :
..nnn. DCt/ICIr%M All IMRFD•
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
LTIR
TYPE OF INSURANCE
ADDL
SUBR
POLICY NUMBER
POLICY EFF
POLICY EXP
LIMITS
A
X
COMMERCIAL GENERAL LIABILITY
EACH OCCURRENCE
$ 1,000,000
CLAIMS -MADE F_X] OCCUR
X
332BOO1865
12/11/2017
12/11/2018
DAMAGE TO RENTED
P M occurren e
100,000
$
MED EXP An one person)$
5,000
PERSONAL & ADV INJURY
$ 1,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
X POLICY ipwT LOC
GENERAL AGGREGATE
$
PRODUCTS - COMP/OP AGG
2,000,000
$ ,000,000
OTHER:
B
AUTOMOBILE LIABILITYaccident)
COMBINED SINGLE LIMIT
1,000,000
$
BODILY INJURY Perperson)
$
ANY AUTO
EBA0237084
03/04/2018
03/04/2019
BODILY INJURY Per accident
$
OWNED X AUTOS SCHEDULED
AUTOS ONLY
X HIRED X NON -OWNED
AUTOS ONLY AUTOS ONLY
Pe�acc�deltDAMAGE
$
C
UMBRELLA LIAB
X
OCCUR
EACH OCCURRENCE
$ 1,000,000
X
AGGREGATE
$
EXCESS LIAB
CLAIMS -MADE
XOBVV7423017
12/11/2017
12/11/2018
$ 1,000,000
DIED RETENTION$
Aggregate
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY
ANY PROPRIETggOR/PARTNER/EXECUTIVE YIN
FICER/ME &EXCLUDED?
N/A
PER ER_
i
E.L. EACH ACCIDENT
$
E.L. DISEASE - EA EMPLOYE
$
E.L. DISEASE E-POLICY LIMIT
$
If yes, describe under
DESCRIPTION OF OPERATIONS below
B
Property
ENP0237084
03/04/2018
03/04/2019
BPP
70,000
DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
City of Fort Collins is named as an additional insured with respect to general liability coverage under form CG2033 04/13.
CERTIFICATE HOLDER cAlvctLLA I IUN
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.
215 N Mason 2nd Floor
P.O. Box 580
Fort Collins, CO 80522 AUTHORIZED REPRESENTATIVE
�T
ACORD 25 (2016/03) CCU 1988-2015 AGUKU GUKF UKA I IUIV. Au ngnis reserveu.
The ACORD name and logo are registered marks of ACORD