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HomeMy WebLinkAboutKYTO INC - INSURANCE CERTIFICATE (9)CUSTOMER NUMBER: 0006755901 AC V 04/28/17 CERTIFICATE OF LIABILITY INSURANCE YY) Ill 4/28/17 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 PHARMACISTS MUTUAL INSURANCE COMPANY 808 HIGHWAY 18 WEST, PO BOX 370 ALGONA, IA 50511-0370 INSURED KYTO INC MOBILITY AND MORE 493 DENVER AVE LOVELAND CO 80537-5129 800-247-5930 INSURERS AFFORDING COVERAGE NAIC # INSURERA:Pharmacists Mutual Insurance Company 13714 INSURER B: INSURER C: INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 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 ADDL INSD SUBR WVD POLICY NUMBER POLICY EFF (MMIDD/YYYY) POLICY EXP (MM/DD/YYYY) _ LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE 1K OCCUR Y BOP 0089544 11 Includes- Health Care Services Liability 07/01/2017 07/01/2018 EACH OCCURRENCE $ 1, 000, 000 DAMAGE TO RENTED PREMISES (Ea occurrence) $ 250, 000 MED EXP (Any one person) $ 5, 000 PERSONAL & ADV INJURY $ INCLUDED - GEN'L AGGREGATE LIMIT APPLIES PER: PRO- POLICY JECT LOC OTHER GENERAL AGGREGATE $ 2, 000, 000 PRODUCTS - COMP/OP AGG $ 2, 000, 000 WATER LEGAL LIABILITY $ 50, 000 A AUTOMOBILE LIABILITY ANY AUTO ALL OWNED X SCHEDULED AUTOS AUTOS X HIRED X NON -OWNED AUTOS AUTOS N N CAU 0089544 10 07/01/2017 07/01/2018 COMBINED SINGLE LIMIT (Ea accident) $ 1, 000, 000 BODILY INJURY (Per person) $ (Per accident) BODILY INJURY $ ______ PROPERTY DAMAGE Per accident $ ____________ $ A VMBEREL, AB X OCCUR CLAIMS -MADE N UCL 0089544 11 07/01/2017 07/01/2018 EACH OCCURRENCE $ 1, 000, 000 AGGREGATE $ 1, 000, 000 ENTION $ 10 , 000 $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNERIEXECUTIVE OFFICER/MEMBER EXCLUDED? Y/N (Mandatory In NH) If yes, describe under ❑ DESCRIPTION OF OPERATIONS below N/A PER OTH STATUTE ER E.L. EACH ACCIDENT $ E.L. DISEASE -EA EMPLOYEE $ E.L. DISEASE -POLICY LIMIT $ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more space is required) Loc:MOBILITY AND MORE 493 DENVER AVE LOVELAND, CO 80537-5129 CERTIFICATE HOLDER CANCELLATION CERT HOLDER/ADDITIONAL INSR ' D SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE CITY OF FORT COLLINS WITH THE POLICY PROVISIONS. PO BOX 580 FORT COLLINS CO 80522 AUTHORIZED REPRESENTATIVE GAIL T. WOLFE, CISR, API ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD