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KOBOBEL FIRE PROTECTION LLC - INSURANCE CERTIFICATE (3)
KOROFIR-01 RTAYLOR '44c"R6 CERTIFICATE OF LIABILITY INSURANCE `--� DATE(MM/DD(YYYY) 09116/2017 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 CoBiz Insurance, Inc. - CO 1401 Lawrence St., Ste. 1200 Denver, CO 80202 CONTACT COBIz PHONE FAX (AIC. No, Ext): (A/C, No):(303) 988-0804 Ek : comail@cobizinsurance.com A�DR INSURERS AFFORDING COVERAGE NAIC S INSURER A:Ironshore Specialty Insurance Co 25445 INSURED INSURER B: Ohio Security Insurance Company 24082 INSURER C : Pinnacol Assurance Company 41190 Kobobel Fire Protection, LLC INSURER D : Houston Casualty Co. 42374 7380 Greendale Rd, Suite B Windsor, CO 80550 INSURER E INSURER F COVERAGES CFRTIFICATF NIIMRFR• RFVISION NIIMRFR- 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 D POLICY EFF POLICY EXP /DD LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR RCS0050101 08/31/2017 08/31/2018 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED $ 100,000 MED EXP (Any oneperson) $ 5,000 PERSONAL S ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY ❑X PEST LOC OTHER: GENERAL AGGREGATE $ 2,000,000 PRODUCTS -COMPIOPAGG $ 2,000,000 JOBSITE POLLUTI $ 500,000 B AUTOMOBILE LIABILITY ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS AUTO ONLY AIOJTNO ONL� BAS57209852 03/15/2017 03/15/2018 COMBINED SINGLE LIMIT $ 1,000 000 X BODILY INJURY Per arson $ BODILYBODILY INJURY Per accident $ P 08E.den AMAGE $ A X UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE RUS0009701 08/31/2017 08/31/2018 EACH OCCURRENCE $ 2,000,000 AGGREGATE $ 2,000,000 DED I X I RETENTION $ 10,000 $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBEREXCLUDED? 71 (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below NIA 4124333 07/01/2017 07/01/2018 X PER OTH- E.L. EACH ACCIDENT •1,000,000 E.L. DISEASE - EA EMPLOYEE 1,000,000 E.L. DISEASE - POLICY LIMIT __ $ 1,000,000 D Professional Liabili HCC1664809 03/15/2017 03/15/2018 Deductible $5,000 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) City of Fort Collins PO Box 580 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 �...:: ... ea. ACORD 25 (2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD