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HomeMy WebLinkAbout357006 ALL AMERICAN BACKFLOW - INSURANCE CERTIFICATE (13)ACAC>JV"'w �-- CERTIFICATE OF LIABILITY INSURANCE DA:11: (mil,DDNYYY) 4/29/2017 THIS CERTIFICATEIS 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 endorsements . PRODUCER AFFORDABLE AMR INS/PHS 343638 P: (866) 467-8730 F: (888) 443-6112 PO BOX 33015 SAN ANTONIO TX 78265 CONTACT NAME: (AIC,No.Ext): (866) 467-8730 is .Nu): (888) 443-6112 A DDR'ESS: INSURER(S) AFFORDING COVERAGE NAIC# INSURERA: Hartford Casualty Ins CC INSURED LYNNETTE KEIM DBA ALL AMERICAN BACKFLOW 3912 W EISENHOWER BLVD LOVE LAND CO 80537 INSURER B : INSURER C INSURERD: INSURERE: 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_ INSB' TYPB`OF fNStrX.9NC`E ADD SUI1 IY)L[CYNtiM1llflill' POLICTEVI, D"TYY 110LICTEXP TIM17B` COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $2 , 000, 000 CLAIMS -MADEOCCUR DAMAGETORENTED PREMISES (Ea occurrence) $300 000 X X MED EXP (Any one person) $10, 000 A General Liab 34 SBA PE5367 05/26/2017 05/26/2018 PERSONAL SADVINJURY s2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE s4,000,000 PRODUCTS - COMP/OP AGG $ �� 000� 000 PRO- � LOC JECT OTHER: AUTOMOBILE LIABILITY nt) SINGLE LIMIT COMBINED (Ea accident) s2,000,000 BODILY INJURY (Per person) $ ANY AUTO A OWNED SCHEDULED AUTOS ONLY AUTOS 34 SEA PE5367 05/26/2017 05/26/2018 BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ X HIRED X NON -OWNED AUTOS ONLY AUTOS ONLY $ X UMBRELLA LAB X OCCUR EACH OCCURRENCE $1 , 000,000 A EXCESS LIAB CLAIMS -MADE 34 SBA PE5367 05/26/2017 05/26/2018 AGGREGATE a1, 000, 000 r_rDE X RETENTION $10 r 0 0 0 woectxs crimrtrvse7ion, PER OTH- AND EAfILUPF"LL4BD.rIY STATUTE ER E.L. EACH ACCIDENT ANY PROPRIETORIPARTNERJEXECUTIVEYIN OFFICER/MEMBER EXCLUDED ❑ (Mandatory in NH) MA E.L. DISEASE- EA EMPLOYEE If yes, describe under E.L. DISEASE -POLICY LIMIT DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS /LOCATIONS /VEHICPMRD 101, Additional Remarks Schedule, may be attached if more space is required) Those usual to the Insured's Operations. rGQTIGIrATI= uni nFR r'ANr'FI I ATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED The City of Fort Collins Y BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZFOREPRESENTATIVE ` Purchasing Dept PO BOX 580Gr✓�_�f�...� FORT COLLINS, CO 80522 ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD ACORD 25 (2016/03)