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HomeMy WebLinkAboutLEI COMPANIES INC - INSURANCE CERTIFICATE (4)Iv526�0028002
ACORO CERTIFICATE OF LIABILITY INSURANCE
09/26ia1n
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 1-303-534-4567
INA, Inc. - Colorado Division
CONTACT
NAME:
PHONE FAX
No):
EMAIL denaccounttechaaimacorp.com
���
1705 17th Street
INSURER(S) AFFORDING COVERAGE
NAIC i
Suite 100
INSl1RERA: WESTFIELD INS CO
24112
Denver, CO 80202
INSURED
INSURER8: PINNACOL ASSDR
41190
LEI Companies, Inc.
INSURER CINDIAN HARBOR INS CO (XL Environmental 33040
INSURER D:
2017 Curtis St
INSURER E :
INSURER F:
Denver, CO 80205
COVERAGES CERTIFICATE NUMBER: 50944522 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
ADOL
SUER
NUMBER
POLIPOLICY
MMIDCY EFF
MPOMIIODY EXP
UMITs
A
X
COMMERCIAL GENERAL LIABILITY
TRA7910440
10/01/17
10/01/18
EACH OCCURRENCE
= 1,000,000
CLAIMS -MADE 1XI OCCUR
DAMAGE TO RENTED
PREMISES Ea occurrence
S 500,000
X
MED EXP (Any one person)
= 10,000
PD DED: $500
PERSONAL BADVINJURY
$ 1,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
GENERAL AGGREGATE
$ 2,000,000
POLICY � JET LOC
PRODUCTS- COMP/OP AGG
$ 2,000,000
1
f
OTHER:
A
AUTOMOBILE LIABILITY
TRA7910440
10/01/17
10/01/18
ICE OMBINESINGLELIMIT
a accidentD
$ 1,000,000
BODILY INJURY (Per person)
i
X ANY AUTO
BODILY INJURY (Par accident)
$
ALL OWNED I SCHEDULED
AUTOS AUTOS
PROPERTY DAMAGE
Par accident
:
NON -OWNED
X HIRED AUTOS X AUTOS
s
A
X
UMBRELLA LIAB
N
OCCUR
TRA7910440
10/01/17
10/01/18
EACH OCCURRENCE
$ 9,000,000
AGGREGATE
$ 9,000,000
EXCESS LIAR
CLAIMS -MADE
DED X RETENTION 0
f
B
WORKERS COMPENSATION
AND EMPLOYERS'LIABILITY
ANY PROPRIETORIPARTNERIEXECUTIVE YIN
OFFICER/MEMBER EXCLUDED?
(Mandatory In NH)
N I A
4062205
10/01/17
10/01/18
X 1 ER
STATUTE ER
E.L. EACH ACCIDENT
$ 1,000,000
E.L. DISEASE - EA EMPLOYEd
$ 1,000,000
E.L. DISEASE - POLICY LIMIT
= 1,000,000
If yes, describe under
DESCRIPTION OF OPERATIONS below
A
Leased & Rented Equipment
TRA7910440
10/01/17
10/01/18
Limit $100,000
Deductible $ 500
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached K mom space Is required)
t.tKIIFIt:AIt NULULK VANI.tLL kIIVN
RE: License #NE-1227.
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
City of Ft. Collins THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
P.O. BOY 580 AUTHORIZED REPRESENTATIVE //",&
Ft. Collins, CO 80522 /
USA iii
©1988-2014 ACORD CORPORATION. All rights reserved.
ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD
epmaestas
50944522
:19
I
DATE
SUPPLEMENT TO CERTIFICATE OF INSURANCE
09/266//2017
NAME OF INSURED: LEI Companies, Inc.
Additional Description of Operations/Remarks from Page 1:
Additional Information:
Installation Floater Coverage: Policy #TRA7910440
Effective Dates: 10/01/2017-10/01/2018 Insurer A: See Above
$780,000 Any One Location; $9,000,000 Per Disaster;
$780,000 Transit; $780,000 Temporary Location; $500 Deductible; SPC Form
Pollution/Professional Combined: Policy #PEC004671802
Effective Dates: 10/01/2017-10/01/2018 Insurer C: See Above
$2,000,000 Each Occurrence; $2,000,000 Aggregate; $10,000 Deductible
SUPP (05/04)