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HomeMy WebLinkAboutED CARROLL MOTOR COMPANY INC - INSURANCE CERTIFICATE (3)A. �' CERTIFICATE OF GARAGE INSURANCE
DAo 0/201D7/Y r
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 endorsements .
PRODUCER
Sentry Insurance Company
1800 North Point Drive
CONTACT SentryCustomer Service
NAME:
A/C, No, Ext : 800-473-6679 FA%C, No : 888-533-7827
Stevens Pant, WI 54481
EMAIL
ADDRESS: businessproducts_ssdotesentry.com
INSURER(S) AFFORDING COVERAGE
NAIC #
INSURER A: SENTRY SELECT INSURANCE COMPANY
21180
INSURED
INSURER B :
ED CARROLL MOTOR COMPANY INC
3003 S COLLEGE AVE
INSURER C :
INSURER D :
FT COLLINS, CO 80525
INSURER E :
INSURER F :
COVERAGES PROD / CUSTOMER ID: CERTIFICATE k: 0002 REVISION li:
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
INSRD
SUBR
WVD
POLICY NUMBER
POLICY EFF
(MM/DD/YYYY)
POLICY EX:)
(MM/DD/YYYY)
LIMITS
A
GARAGE LIABILITY
ALLOWNED [_EX]HIR D AUTOS
AUTOS
NON -OWNED AUTOS
USED IN GARAGE BUSINESS
IX
25-57028-04
03/01/2017
03/01/2018
AUTO ONLY (Ea accident)
$ 500,000
OTHER THAN
AUTO ONLY Y
EA ACCIDENT
$500,000
AGGREGATE
$ 2,500,000
GARAGE KEEPERS LIABILITY
LEGAL LIABILITY
DIRECT BASIS
PRIMARY F EXCESS
COMP /
OTC LOC
SPECIFIED LOC
$
$
COLLISION LOC
LOC
$
$
COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE ❑ OCCUR
EACH OCCURRENCE
$
DAMAGE TO RENTED
PREMISES a occurrence
$
GENT
MED EXP (Any one person)
$
PERSONAL & ADV INJURY
$
AGGREGATE LIMIT APPLIES PER:
POLICY ❑PRO- El LOC
JECT
OTHER
GENERAL AGGREGATE
$
PRODUCTS -COMP/OP AGG
$
$
A
X UMBRELLA LIAR
X EXCESS LIAR
X
OCCUR
CLAIMS -MADE
25-57028-04
03/01/2017
03/01/2018
EACH OCCURRENCE
$ 5,000,000
AGGREGATE
$ 15,000,000
DED I I RETENTION $
PRODUCTS - COMP/OP AGG
$ 15,000,000
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY
ANY PRO PRIETOR/PARTNER'EXECUTNE
OFFICER/MEMBER EXCLUDED? Y / N
(Mandatory in NH) ❑
If yes, describe under
REMARKS below
N / A
PER
STATUTE
E.L. EACH ACCIDENT
$
E.L. DISEASE - FA EMPLOYEE
$
E.L. DISEASE - POLICY LIMIT
$
REMARKS (ACORD 101, Additional Remarks Schedule, may be attached it more space is required)
Refer to attached
CERTIFICATE HOLDER CANCELLATION
CITY OF FORT COLLINS
RISK MANAGEMENT
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.
N
ACORD 30 (2014/01)
2557028 0002
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The ACORD name and logo are registered marks of ACORD
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01/20/2017