HomeMy WebLinkAboutHAHN PLUMBING & HEATING INC - INSURANCE CERTIFICATE 2023-2024A/'—/"y � DATE (MM/OD/YVVY)
r�-�"� CERTIFICATE OF LIABILITY INSURANCE
08/16/2023
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIOHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE
DOES NOT AFFIRMATIVELY OR NEOATIVELY 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 ADDI710NAL INSURED provisions or be endorsed. If
SUBROOATION IS WAIVED, subject to the terms and conditions of the policy, certain policias may require an endorsement. A statement on this
certificate does not corifer rights to the certificate holder in lieu of such endorsement(s).
PRODUCER r�inME �T CLIENT CONTACT CENTER
FEDERATED MUTUALINSURANCE COMPANY PHONE Fax
HOME OFFICE: P.O. BOX 328 1/�/c, No, Ext�: 88&333-4949 IA/c, Nol: 507-446-4664
OWATONNA, MN 55060 a.00a�Ess: CLIENTCONTACTCENTER(a1FEDINS.COM
INSURED
HAHN PLUMBING & HEATING, INC.
130 CHESTNUT ST
FORT COLLINS, CO 805242403
COVERAGES
CERTIFICATE NUMBER: 136
INSURERS AFFORDING COVEftAGE NAIC #
iNsuREa n:FEDERATED MUTUAL INSURANCE COMPANY 13935
314-001-9 iusuaea e: FEDERATED SERVICE INSURANCE COMPANY 28304
INSURER C:
INSURER D:
INSURER E:
INSURER F:
REVISION NUMBER: 1
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 INSURPNCE FlDDL SUBR pOLICY NUMBER POLICY EFF POLICY EXP UMITS
X COMMERCIAL GENERAL IIABILITY EACH OCCURRENCE $�,OOO,OOO
CLAIMS-MADE ❑X OCCUR DAMACE TO RENTED PREMISES $jOO,O00
MED EXP (My one person) EXCLUDED
A N N 1869040 OtIO11ZOZ3 O1IO1I2O24 pERSONru 8 anVINJURY $1 OOO OOO
CENL AGCREGATE lIM1T APPLIES PER: GENERAL ACGREGATE 2 OOO OOO
X POUCY �RO- � ��� PRODUCTS 8 COMP/OP AGG S2,QOO,OOO
ECT
OTHER:
AUTOMOBILE LIABILITY COMBINED SINOLE LJMIT $1,000,000
Ea accident
%� ANYAUTO BODILV INJURV (Per Penon)
A OWNEDAUTOSONLV AUTODULED N N �869�4� ��/��/2�23 01/01l2024 BODILYINJURY�PerAccidenl)
HIREDAUTOS ONLY qUT0.S ONL�Y PROPER �DAMAGE
X UMBRELLA LIAB X pCCUR EACH OCCURRENCE $'I,OOO,OOO
B EXCESSLIAB CLAIMStdAOE N N �8s9a4� O1/O1/20'23 01/01/2024 AGGREGATE �i,�0�,000
DED RETENTIQ'J
WORKERS COMPENSATION X PER STATUTE 7HER
AND EMPLOYERS' LIABILITY Y/N
ANY PROPRIETORIPARTNERI EXECUTIVE E.L EACH ACCIOENT $'I�OOO,OOO
(\ OFFlCER/MEMBERE%CLUDED7 N/A N 1869043 Oi/Oi/ZOZ3 Oi/Oi/2024
(Mentlalory in NH) E.L DISEASE fA EMPLOVEE $i,DOD,�O
If yes, tle5cribe inEer
DESCRIPTION OF OPERATIONS helow E.L DISEASE � POLICY LIMIT $�,OOO,OOO
DESCRIPTION OF OPERATIONS / LOCATIONS 1 VEHICLES (ACORO 101, Additional Remarks Schedule, may be affiched if more space is required)
POLICY COVERAGE AS OF OS/15/2023
CERTIFICATE HOLDER
314-001-9
CITY OF FORT COLLINS
FORT COLLINS UTILITIES
PO BOX 580
FORT COL�INS, CO 80522-0580
�� � I SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED
BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICV PROVISIONS.
AUTHORIZEDREPRESENTATIVE �� � `�
L .. _a_
v ���
CANCELLATION
O 1988-2015 ACORD CORPORATION. All ricjits reserved.
ACORD 25 (2076/0.?) The ACORD name and logo are registered marks of ACORD
A y,�� � DATE (MM/DOM'YV)
�- CERTIFICATE OF LIABILITY INSURANCE 08/16/2023
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIOHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE
DOES NOT AFFIRMATIVELY OR NEOATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF
INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUINO 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
SUBROOATION 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).
PROOUCER ranME �T CLIENT CONTACT CENTER
FEDERATED MUTUAL INSURANCE COMPANY PHONE FAx
HOME OFFICE: P.O. BOX 328 IA/c, No, ext1: 886-333-4949 IA/C, No�: 507-446-4664
OWATONNA, MN 55060 wooR�Ess:CLIENTCONTACTCENTER(a�FEDINS.COM
INSURED
HAHN PLUMBING & HEATING, INC.
130 CHESTNUT ST
FORT COLLINS, CO 805242403
INSURERS AFFORDING COVERAGE NAIC A
iNsuaeR n:FEDERATED MUTUAL INSURANCE COMPANY 13935
314-001-9 iusuREre e: FEDERATED SERVICE INSURANCE COMPANY 28304
INSURER C:
INSURER D:
INSURER E�
INSURER F:
COVERAGES CERTIFICATE NUMBER: 135 REVISION NUMBER: 1
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE PO�ICY 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 POIICiES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR 7ypE OF INSURPNCE P�DDL SUBR pp��CY NUMBER POLICY EFF POIJCV EXP LIMITS
X COMMERdALGENERALLIABILITY EACHOCCURRENCE $�,O00,000
CLAIMS•MADE ❑X OCCUR DAMAGE TO RENTEO PREMISES $'IOO,OOO
MED EXP (My one person) EXCLUDED
q N N 1869040 01/01/2023 O1l01/2024 pERSONALB ADVINJURV 1 �00 000
GENL ACCREGA7E LIMI7 APPLIES PER: GENERAL AGGREGATE Z OOO OOO
X POLICY �jE�T ❑ lOC PRODUGTS 6 COMP/OP AGG 52,000,000
OTHER:
AUTOMOBILE LIABILJTY E�MB�NdeD SINOLE LIMIT $1,000,000
%� ANYAUTO BODILV INJURV (Per Perzon)
A OWNEDAUTOSONLY SCHEDULED N N �869�40 �l/��/2�23 01l01l2024 BODILYINJURY�PerAcciden�
AUT0.S
NON-OWNED PROPERTY DAMAGE
HIRED AUTOS ONLY qUT0.S ONLY -�de°
%� UMBRELLA LIAB x pCCUR EACH OCCURRENCE $�,OOO,OOO
B EXCESSLIAB CLAIMS-MADE N N �8BJO4'I O�/OVZOZ3 O�/O�/ZOP4 AGGREGATE S�,OOO,OOO
DED RETENTIQ'J
WORKERS COMPENSATION X PER STATUTE DTHER
ANO EMPLOYERS' IIABILITV y/ry
ANV PROPRIETOR/PARTNERI EXECUTIVE E.l EACH ACCIDENT $1,000,000
A OFFICERIMEMBEREXCLUDED4 NIA N 1869043 O�IOiIZO23 O'IIO�I2O24
(Mentletory in NH) E.L DISEASE fAEMPLOVEE �i3OOO,OOO
If yes, CescrlEe inder
DESCRIPTION OF OPERATIONS 6elow E.L DISEASE � POLICV LIMIT $'I,OOO,OOO
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 107, Additional Remarks Schedule, may be atlached if more zpace is required)
POLICY COVERAGE AS OF OS/15/2023
CERTIFICATE HOLDER CANCELIATION
314-001-9 1351 SHOULD ANY OF THE ABOVE DESCRIBED POUCIES BE CANCELLED
CITY OF FORT COLLINS UTILITIES DEPARTMENT
PO BOX 580 BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
FORT COLLINS, CO 80522-0580 ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE � G,�
� 1988•2015 ACORD CORPORATION. All rights reserved.
ACORD 25 (2016ro3) The ACORD name and logo are registered marks of ACORD