HomeMy WebLinkAboutSTEEL-T HEATING INC - INSURANCE CERTIFICATE (4)N;uaazxwz
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CERTIFICATE OF LIABILITY INSURANCE 09/25/2017
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 endorsement(s).
PRODUCER 1-303-534-4567 CONTACT
NAME:__
INA, Inc. - Colorado Division PHONE FAX
1A1� 114 Extl LAIC. NO1:
E-MAIL DenaCCOUntteCbA%'=COrp.CCta
1705 17th Street ADDRESS:
Suite 100 INSURERS AFFORDING COVERAGE NAIL#
Denver, CO 80202 INSURERA: UNITED SPECIALTY INS CO(All Risks Ltd) 12537
INSURED INSURERS: WESTFIELD INS CO 24112
Steel-T Seating Inc. INSURERC: TRAVELERS EXCESS & SURPLUS LINES CO 29696
2750 S. Shoshone Street, Suite 240 INSURER D:
INSURER E :
Englewood, CO 80110 INSURERF:
nrrirronwrr RFVISInN NIIMRFR-
vTHIS•IS 10 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
SUER
NUMBER
MMIDCY EFF
POLIPOLICY
MP�p EXP
LIMITS
A
X
COMMERCIAL GENERALLIABILRY
CLAIMS-MADE OCCUR
AGGREGATE LIMI r APPLIES PER:
POLICY L_J PRO- LOC
JECT
OTHER.
I
ATNATL1740654
I
10/01/17
10/01/18
EACH OCCURRENCE
S 1,000,000
GEN'L
--
GE TO REN-TED-
REM SES Ea occurrence
f 501000
MED EXP (Any one person)
$ EXCLUDED
PERSONAL BADVINJURY
S 1,000,000
GENERAL AGGREGATE
S 2,000,000
PRODUCTS - COMP/OP AGG
$ 2,000,000
s
B
AUTOMOBILE LIABILITYTRA8314878
X ANY AUTO
ALL OWNED SCHEDULED
AUTOS AUTOS
NON -OWNED
X HIRED AUTOS X AUTOS(Per
10/01/17
10/01/18
CMBINED SINGLE LIMIT
EaOa�ient
$
BODILY INJURY (Per person)
S 1,000,000
BODILY INJURY (Per accident)
$ 1,000,000
PROPERTY DAMAGE
sociderm
S
i
C
X
UMBRELLA LIAB
EXCESS LIAB
X
OCCUR
CLAIMS -MADE
ZUP91M4246717NF
10/01/17
10/01/18
EACH OCCURRENCE
$ 2,000,000
AGGREGATE
$ 2,000,000
DED X RETENTIONS 10, 000
$
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY Y 1 N
ANY PROPRIETOR/PARTNERIEXECUTIVE ❑
OFFICER/MEMBER EXCLUDED?
(Mandatory In NH)
If yes, describe under
DESCRIPTION OF OPERATIONS below
N / A
STOAT TE )TH-
E.L. EACH ACCIDENT
$
E.L. DISEASE - EA EMPLOYE
$
E.L. DISEASE - POLICY LIMIT
$
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached N man space Is n lulrW)
rAurcr r Arrnru
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
City of Fort Collins
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
215 M. Mason Street 2nd Floor
AUTHORIZED REPRESENTATIVE
Fort Collino, Co 80522
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USA
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ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD
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