Loading...
HomeMy WebLinkAboutBENSON ROLL-OFF SERVICES LLC - INSURANCE CERTIFICATE (5)BENSO-1 OP ID: JD ACORO' CERTIFICATE OF LIABILITY INSURANCE DATE (M9/20 11 /0/207 17 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 CONTACT Brown & Brown Inc NAME: Jody Wagner 4532 Boardwalk Dr, Suite 200 (AICNN Ext;970-482-7747 jA No): 970-484-4165 Fort Collins, h 80525 ADDRESS: jwagner@bbcolorado.com William S. Rich — INSURER(S) AFFORDING COVERAGE NAIC p INSURER A: American Automobile Ins Co 21849 INSURED - Benson Roll -Off Services, LLC INSURER B:Argonaut Insurance Company 19801 6885 Lowell Blvd. Denver, CO 80221 INSURERC: INSURER D : INSURER E : INSURER IF: COVERAGES CERTIFICATE NUMRFR: RFVISION NIIMRFR: 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 ADDL SUBli- POLICY NUMBER POLICY EFF 7 MMIDD/YYYY�(MMIDDIYYYY)LIMITS POLICY EXP A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE T OCCUR MXG80982994 11/07/2017 11/07/2018 EACH OCCURRENCE $ 1,000,000 PREMISES Ea occurrence $ 100,000 MED EXP (Any one person) $ 5,000 GEN'L PERSONAL & ADV INJURY $ 1,000,000 AGGREGATE LIMIT APPLIES PER: POLICY ❑ PRO- JECTE LOC OTHER: GENERAL AGGREGATE $ 2,000,00 PRODUCTS - COMP/OP AGG $ 2,000,00 $ A AUTOMOBILE LIABILITY ANY AUTO ALL OWNED X7 SCHEDULED AUTOS AUTS O X NON -OWNED HIRED AUTOS AUTOS MXG80982994 11/07/2017 11/07/2018 COMBINED SINGLE LIMIT Ea accident_ $ 1,000,000 X BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTYDAMAGE Per accident $ _ $ UMBRELLA LIAB EXCESS LIAB OCCUR EACH OCCURRENCE $ HCLAIMS-MADE AGGREGATE $ DED RETENTION $ $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y / N OFFICER/MEMBER EXCLUDED? ❑.N/A (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below IWC928218472974 12101/2016 12101/2017 X PER OTH- STATUTE ER E.L. EACH ACCIDENT $ 1,000,00 E.L. DISEASE - EA EMPLOYE $ 1,000,00 E.L. DISEASE - POLICY LIMIT 1 $ 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) CtK I IFIL:A I L HL)LUtK CITYFC2 City of Fort Collins PO Box 580 Fort Collins, CO 80522 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE Y4,v3w% - © 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD BENso-1 PAGE 2 NOTEPAD INSURED'S NAME Benson Roll -Off Services, LLC OP ID: JD Date 11/09/2017 If required in a written contract, the following endorsements apply on a blanket basis: General Liability: CG7193 (01/14) - Includes additional insured, primary and non-contributory provision for additional insureds, automatic waiver of rights of subrogation to Liability: 7018 (10/14) - Includes additional insured and waiver of rights of brogation 9948 - Broadened Pollution Coverage