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HomeMy WebLinkAboutINLET STRUCTURES INC - INSURANCE CERTIFICATE (12)IN LESTR-01 MARE „�+►coRo CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DDYYYY) �-� 05/24/2017 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 Six & Geving Insurance, Inc. 225 Union Blvd. Suite 575 Lakewood, CO 80228 INSURED Inlet Structures Inc. Danny 8: Rachel Garza 5110 York St Denver, CO 80216 Shaleen Martin e►: (720) 962-0930 INSURER F : tFA►�c, No):(720) 962-0942 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 TYPE OF INSURANCE ADDL;SUBR POLICY NUMBER POLICY EFF POLICY EXPLTR LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE X OCCUR X 3X23855 06/02/2017 06/0212018 EACH OCCURRENCE DAMAGE TO RENTED PREMISES (Ea occurroa MED EXP (Any one person PERSONAL & ADV INJURY GENERAL AGGREGATE PRODUCTS - COMP/OP AGG $ 1,000,000 300,000 $ $ 5,000 $ 1,000,000 GENT AGGREGATE LIMIT APPLIES PER: POLICY FX] jPC(� E LOC OTHER: $ 2,000,000 $ 2,000,000 A AUTOMOBILE X LIABILITY ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS AUE N Vy p TOS ONLY AUTO ONLY 3X23855 06102/2017 06/0212018 COMBINED SINGLE LIMIT (Ea accident _ _ BODILY INJURY Per rson BODILY INJURY Per accident erOacEaRTYdenAMAGE 1,000,000 $ $ $ $ A X UMBRELLA LIAB X !OCCUR EXCESS LAB CLAIMS -MADE DED I X I RETENTION $ 10,000 3X23855 06/02/2017 06/02/2018 EACH OCCURRENCE AGGREGATE 5,000,000 5,000,000 B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y I N ANY PROPRIETOR/PARTNER/EXECUTIVE FFICER/MEMBER EXCLUDED? N Mandatoryin NH) If yes, deccrlbc under DESCRIPTION OF OPERATIONS below N /A 4018512 04/01 /2017 04/01 /2018 X SWTUTE� OTH- E.L. EACH ACCIDENT___ E.L. DISEASE - EA EMPLOYEE E.L. DISEASE - POLICY LIMIT 1,000,000 1,000,000 1,000,000 I DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) City of Fort Collins is named as additional insured as respects General Liability if required by written contract. II 4Z41120111 I ME:1091 RUAV 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. AUTHORIZED REPRESENTATIVE ACORD 25 (2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD