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HomeMy WebLinkAbout568067 WHAYNE ENTERPRISES - INSURANCE CERTIFICATE (4)�-� WHAY&SO-01 MSWAIM ACORO CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 06/29/2018 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 CONTACT Forsberg Engerman Co A/C, o, Ext); (303) 762-1717 FAA/c, No :(303) 762-1733 3575 S Sherman St E-MAIL Englewood, CO 80113 ADDRESS: INSURERISI AFFORDING COVERAGE NAIC # INSURED Whayne and Sons Enterprises dba Whayne Enterprises 10515 E 40th Ave #103 Denver, CO 80239 A:EMC I INSURER F : fInwCDAnme !`GDTICIr ATF NI IMRFD• RFVICI(,1N NI IMRFR• 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 LTRA TYPE OF INSURANCE ADDL SINSD yyUVBp POLICY NUMBER POLICY EFF POLICY EXP LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE X OCCUR X 4D75619 07/01/2018 07/01/2019 DAMAGES(TO RENTED PR MI E a oc rr n 900,000 $ MED EXP (Any oneperson) $ 5,000 PERSONAL& ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP/OP AGG $ 2,000,000 X POLICY 71 PRe� LOC $ OTHER: A AUTOMOBILE LIABILITY Ea .deDtSINGLE LIMIT $ 1,000,000 BODILY INJURY Perperson) $ X ANY AUTO X 4E75619 07/01/2018 07/01/2019 BODILY INJURY Per accident $ OWNED SCHEDULED AUTOS ONLY AUTOS FIRPERAMAGE $ X HIRED X NON -OWNED AUTOS ONLY AUTOS ONLY A X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 5,000,000 EXCESS LIAB CLAIMS -MADE 4J75619 07/01/2018 07/01/2019 AGGREGATE $ 5,000,000 DED I X I RETENTION $ 10,000 $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANYPROPRIETOR/PARTNER/EXECUTIVE Y 4157055 07/01/2018 07/01/2019 PER OTH- TAT T E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE 1,000,000 $ OFFICER/MEMBER EXCLUDED? (Mandatory in NH) N/A E.L. DISEASE - POLICY LIMIT 1,000,000 $ If yes, describe under DESCRIPTION OF OPERATIONS below A Inland Marine 4C75619 07/01/2018 07/01/2019 Leased/Rented 35,000 C Pollution Liability G46852527001- POLLUTION 01/01/2018 1 01/01/2019 Aggregate 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) City of Fort Collins is included as an Additional Insured with respect to General Liability and Auto Liability as required by written contract. CtK I IFIGA I t HVLUtK l HIV �.CLLH 1 IVIV City of Fort Collins PO 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 <Jti^ W ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD