Loading...
HomeMy WebLinkAbout474788 ALL STRIPES & MAINTENANCE LLC - INSURANCE CERTIFICATE (12)AC �® DATE (MM/DDIYYYY) CERTIFICATE OF LIABILITY INSURANCE 1/19/2017 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). CONTACT PRODUCER Liberty Mutual Insurance NAME, PO Box 188065 PHONE 800-962-7132 ivC, No): 800-845-3666 Fairfield, OH 45018 1 E-MAIL I.._: ---- o__.:__.a ___ NAIC # INSURED All Stripes & Maintenance LLC PO Box 1399 Fort Collins CO 80522 INSURER A: INSURER B : INSURERC: INSURERD: INSURER E : rnVFRAnPR CFRTIFICATF NIIMRFR• 12RQ9Cd5l REVISION Nt1MRFR: 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 ADDLiSUBR POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DD/YYYY LIMITS A ✓ COMMERCIAL GENERAL LIABILITY ✓ BKS55859658 2/28/2017 2/28/2018 EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE I OCCUR DAMAGE To RENTED PREMISES Ea occurrence) $ 300,000 MED EXP (Any one person) $ 15,000 PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 PRODUCTS -COMP/OP AGG $ 2,000,000 PRO ✓ POLICY JECT LOC $ OTHER: AUTOMOBILE LIABILITY ANY AUTO COMBINED SINGLE LIMIT Ea accident $ BODILY INJURY (Per person) $ r OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED I AUTOS ONLY AUTOS ONLY BODILY INJURY (Per accident) $ PPec OPPERde DAMAGE $ $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DED RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANYPROPRIETOR/PARTNER/EXECUTIVE ER OTH- STATUTE ER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ OFF ICER/MEMBER EXCLUDED? D (Man datory in NH) NIA E.L. DISEASE -POLICY LIMIT $ If yes, describe under DESCRIPTION OF OPERATIONS below li I DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) City of Fort Collins, Purchasing Division is Additional Insured if required by written contract or written agreement subject to General Liability Blanket Additional Insured Provision. L:tKIIt-IGAIt MULL11=11 11M14VGL1..M11W1Y SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Fort Collins THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Purchasing Division ACCORDANCE WITH THE POLICY PROVISIONS. PO Box 58 Fort Collins CO 80522 AUTHORIZED REPRESENTATIVE ' DWAA0.Q1 "isL Desirae Mohr © 1988-2015 ACORD COKPOKA I IUN. All ngnts reserves. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD 33832348 1 55859658 1 17-18 Master Certificate I Desirae Mohr 1 1/19/2017 11:58:27 AM (EDT) I Page 1 of