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HomeMy WebLinkAbout453112 DIVERSIFIED BODY AND PAINT SHOP - INSURANCE CERTIFICATEPolicy Number: Date Entered: 1/23/2018 ACORO� CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DDNYYY) F9/13/2017 `� 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). PRODUCER P and G Insurance Professionals, LLC CONTACT NHONE AME: AIC 0 Ell:(303)478-4582 FAX No: (888)791-4038 PO Sox 22724 ,E-MAIL s: shawn.gerdes@pandgip.com Denver, CO 80222 INSURERS) AFFORDING COVERAGE NAIC # INSURERA:Auto-Owners Insurance 18988 INSURED Diversified Body and Paint Shop, In INSURER B: INSURER0: Steve Wolfe INSURERD: 4909 FOX St INSURER E: Denver, CO 80216 INSURER F : rnVFRAnFS CFRTIFICATF 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 SUBR POLICY NUMBER EFF MM/DDPOLICY/YYYY POLICY E XP MMIDDNYYY LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $1,000,000 CLAIMS -MADE E OCCUR X 51-039790-00 2/1/2018 2/2/2019 PREMSES� aoccREITurence $ MED EXP (Any oneperson) $ 5 , 00 0 PERSONAL & ADV INJURY $1,000,000 L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $3,000,000 PRO- POLICY❑PRO LOC 70THER PRODUCTS-COMP/OPAGG$3,000,000 $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $1,000,000 A ANYAUTO X 51-039790-00 2/1/2018 2/1/2019 BODILY INJURY (Per person) $ OWNED SCHEDULED BODILY INJURY (Per accident) $ AUTOS ONLY AUTOS PROPERTY DAMAGE Per accident $ HIRED NON -OWNED AUTOS ONLY AUTOS ONLY A UMBRELLA LIAB OCCUR EACH OCCURRENCE $ 2, 000, 000 AGGREGATE $2,000,000 EXCESS LIAB CLAIMS -MADE 51-039790-00 2/1/2018 2/1/2019 i DED I I RETENTION $ $ WORKERS COMPENSATION PER OTH- STATUTE ER AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? N Ip` (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT $ If yes, describe under DESCRIPTION OF OPERATIONS below A Garagekeepers,On hook 51-039790-00 02/01/2018 02/01/2019 comp and toll 2,000,000 A Garage Liability 51-039790-00 02/01/2018 02/01/2019 11000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Cert holder is additional insured for general and auto liabilty. GEKTIFIGA I t HULUtK UANUMLLA I IUN City of Fort Collins PO Box 580 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Fort Collins, CO 80522 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE S ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD Produced usina Forms Boss Plus software. www.Forms Boss. com: Impressive Publishina 800-208-1977