HomeMy WebLinkAbout340571 MAX FIRE APPARATUS INC - INSURANCE CERTIFICATE (13)1 ®
ACORb CERTIFICATE OF LIABILITY INSURANCE
�,.1
-DATE
3/10/2017
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 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
Commercial Risk Solutions
6600 E Hampden Ave Ste 200
Denver CO
CONTACT
NAME:
PHONE 303-996-7801 FAX 303-757-7719
E-MAILUVC,
VBrown@crsdenver.com
INSURERS AFFORDING COVERAGE
NAIC #
INSURERA:Auto-Owners Insurance
18988
INSURED MAXFI-1
INSURER B :
INSURERC:
Max Fire Apparatus, Inc.
Michaela Bacon
P.O. Box 1658
INSURER D :
INSURER E:
Castle Rock CO 80104
INSURER F :
COVERAGES CFRTIFICATF NIIMRFR• 1301872895 RFVICIr1N IVIIMRFR-
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 AUULIbUISKI TYPE OF INSURANCE POLICY EFF POLICY EXP
LTR INSD WVD POLICY NUMBER MM/DD/YYYY MM/DD/YYYY LIMITS
A
X
COMMERCIAL GENERAL LIABILITY
Y
74126517
3/14/2017
3/14/2018
EACH OCCURRENCE
$1,000,000
CLAIMS -MADE U OCCUR
DAMAGE TO RENTED
PREMISES Ea occurrence
_
$300,000
ME EXP (Any one person)
$10,000
PERSONAL & ADV INJURY
$1,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
GENERAL AGGREGATE
$2,000,000
X POLICY F PRO-
JECT E LOC
PRODUCTS - COMP/OP AGG
$2,000,000
$
OTHER
A
AUTOMOBILE
LIABILITY
4960687101
3/17/2017
3/17/2018
COMBINED SINGLE LIMIT$
Ea accident
1,000,000
X
BODILY INJURY (Per person)
$
ANY AUTO
ALL OWNED SCHEDULED
AUTOS AUTOS
BODILY INJURY Per accident
( )
$
HIRED AUTOS X NON -OWNED
AUTOS
X
PROPERTY DAMAGE
Per accident
$
UMBRELLA LIAB
OCCUR
EACH OCCURRENCE
$
AGGREGATE
$
EXCESS LIAB
CLAIMS -MADE
DED I RETENTION $
$
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY Y / N
ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICER/MEMBER EXCLUDED?
PER OTH-
STATUTE ER
NO COVERAGE
$
E.L. EACH ACCIDENT
E.L. DISEASE - EA EMPLOYEE
$
(Mandatory in NH)
If yes, describe under
— - -- _---
E L DISEASE - POLICY LIMIT
DESCRIPTION OF OPERATIONS below
1 $
A
Garage & Dealers
4960687100
3/14/2017
1/14/2018
Each Accident 1,000,000
Aggregate 2,000,000
MEd Pay 10,000
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
Re: Fleet Maintenance. City of Fort Collins is included as additional insured on the General Liability with respect to ongoing operations of the
named insured for the certificate holder as required by written contract. All policy terms, conditions and exclusions apply.
vLn r rrwr r L nvLVLr% L ANt r-LLA I IUN
City of Fort Collins
P.O. 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.
REPRESENTATIVE J
1988-2014 ACORD CORPORATION. All rights reserved.
ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD