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Home My WebLink AboutJOCELYN GENTRY TAP TRUCK FORT COLLINS - INSURANCE CERTIFICATESTtLRIRINS 220 S WILCOX ST #87 CA57LE ROCK, CO 80104 643259 7501 1 AB 0.547 PPACSO4W 024 OQ7501 City of Fort Collins 215 NORTH MASON ST FORT COLLINS, CO SQ524 EI�II�III�II�II�'�I��I��11'�'r�llII�11�111�1�1""I11��'�1��111" Additional insured endorsement PROGi9fll/Uf' C0�41M£RC/.4L Roficy numher: 957173573 Uaderwritten by: Artisan and Trucfcers Casualty Co Insured: Jocelyn Gentry January Z3, 2024 Policy Penud: Apr 4, Z023 - Apr 4. 2,^,24 Mailing Address Artisan and Tru�k�r. Casualty C:, FO Box 947:9 �leve and OH 441C1 1-800-444-4487 Narne of Person or Organization F:��r customer service, z� hour: a day, City oi Fort Collins ? days a w�ek 215 North Mason St Fort CoElins, CO 80524 This endoisement modifies insurance provided under the tornmercial auto policy and any endorseEnents thereto affording liability coverage. The person or organization named above is an insured wiih respec[ to such liability �overage as is affarded by the policy, but this insurance applies to said insured anly as a person liable for the conduct ot another insured and then only to the extent of that liabiiiiy. We also agree with you that insurance provided by this endorsement will be primary for any power unit specifically described on the Declarations Page and showing liabiliry coverage. limit of Liability Bodily Injury Property pamage Combined Liability Not applicable Not applicable $1,Od0,000 each accident All ather terms, Eimits and provisions of this policy remain unchanged. This endoisement applies to Policy Numbei: 457173573 Issued to (Name of Insured): locelyn Gentry iap Truck Fort Colhns Effedive date of endorsement: lanuary 22, 2024 Policy expirahpn date: April 4, 2024 Foim I i98 (0' i6; � � DATE (MMlDUlYYYI'� A�� o CERTIFICATE OF LfABILITY INSURANCE 01/24/2024 �THIS CERTIFICATE fS ISSUED AS A MATTER OF fNFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMA7IVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. TFlIS CERTIFICATE OF INSURANCE DQES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AU7HORIZEQ REPRESENTATIVE OR Pf20DUCER, AND TNE CERTIFfCATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If Sl18ROGATION 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 NAME: T Austin Olivier Black Fiills InsuranceAgency PHONE (605) 342-5555 (605) 342 7901 NC No Ezt : NC No : 820 St. Joseph E'MA�� austinolivier@blackhillsagency.com AD�RESS: PO Box 3330 INSURER(S) AFFORDING COVERAGE NAIC p Rapid City SD 57709 iNsuReRa: Acuity Insurance 14784 INSURED uie�mee e. Dynamic Homes Of Colorado Inc 717 N 22nd Rd Unadilla, NE 68454 COVERAGES CER7IFICA7� NUMBER: CL2412426207 THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUEO TO THE INSUftED NAMED A80VE FOR 7HE POLICY PERIOD INDICATED. NOTWITHSTANDINGANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT Oft OTHER DOCUMENT WITH RESPECT TO UVHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TOALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMI7S SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS � TR TYPE OF 1NSURANCE INSD WV� POLICY NUMBER M�pD EFF MMIDDlYYYY LIMITS X COMMERCIAL GENEf1AL LIABILITY EACH OCCURRENCE b��000,000 CLAIMS-MADE � OCCUR PREMISES Eaoccurrence y�00,000 MED EXP (Any one person) a 5,000 A Z90859 0�/i1�2024 01/1112�25 p�RSONALBADVINJURY b�'��,�� GEN'LAGGREGATELIMITAPPLIESPER� GENERALAGGREGATE E 2�000,000 POLICY � PR� � 2,OOQ,000 JECT LOC PRODUCTS-COMPlOPAGG S OTHER: S AUTOMOBILE LfABILITY COMBINED SINGLE LIMIT a j�QOO,OOO Ea acddenl ANY AUTO BODILY INJURY (Per personl 5 q OVVNED SCHEOl1LED Z90859 01/11 /2024 01/1112025 BODiLY INJURY (Per accidonl) E AUTOS ONLY AUSOS HIRED NON-ONMED PROPERTY DAMAGE a AUTOS ONLY x AUTOS ONLY Per accident 5 UMBRBLLA LfAB OCCUR EACH pCCURRENCE b 1.000,000 A EXCESSLfAB CLAIMS-MADE Z908S9 O7/11IZOZA O7/11/2OZS qGGREGATE E��OOO,OOO DEO RETENTION S E WORKERS COMPENSATIOM X STn UTE �RH AND EMPLOYERS' LIABILITY y � N 500.00Q A ANYPROPRIETORIPARTNERfEXECII�IVE � NIA Z9O$S9 01/11I2O24 O�/li(2025 ��CHACCIOENT E OFFICER/MEMBER EXCLUDED7 (MenQdtory in NH) E l. DISEASE - EA EMPLOY�� E S�� a �( yes, descnbe under 500 000 QESCRIPTION OF OPERATIpNS bataw f l. DISEASE - POLICY LIMIT S DESCRIPTIpN pF OPERATIONS! LOCATIONS! VEHtCLES (ACORD 701,Adtllllonal Remarks Schedule, may Ce attached if more space la requlred) City of Fort Collins 281 N College Ave Forl Collins ACORD 25 (2U16103) CO 80524 INSURER C : INSURER D : INSURER E : INSURER F : REVISlON NUMBER: SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLE� BEFORE THE EXPiRATION DATE THEREOF, [iOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORI2ED REPRESENTATIVE O 1986-2015ACORD CORPQRATION. All rights reserved. The ACORD name and logo are registered marks of ACORb �� ACORO' �� SHABUIL-01 CERTIFICATE OF LIABILITY INSURANCE DATE (MMlDDJYYYY) 1/25/2024 THIS GERTIFICATE IS ISSUED AS A MATTER OF INFORMATION pNLY ANp 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 DbES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUIlJG INSURER{S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLOER. IMPORTANT: If the tertificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITlONAL 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 conter ris�hts to the certificate holder in lieu of such endorsement{s}. PRODUCER PFS Insurance Group A648 Thompson Parkway Suite 200 Johnstown, CO 8U534 INSURED Shamrock Buildings, LLC 3809 Weicker Drive Fort Collins, CO 80524 Valerie Mathiason «,: {970} 635-9400 nsurance.com INSURER A : EMC_PCOp@i'� S� col Assurance Co :c_ INSURER F : 25186 41190 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 NOTIMTHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT Oft OTHER OOCUMENT WITH RESPECT TO WHICH THIS CEF2TIFICATE MAY BE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCFi POL�CIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ^TypE OF INSURANCE Y�ADDL SUBR,� pp�ICY NUMBER POUCY EFF POLICY E%P LIMITS A X COIWMERCIAL GENERAL LIABILITY EACH OCCURRENCE g �,OOO,OOO I� CLAIMS•MADE X OCCUR 6D52215 2/i/2424 211J2025 DAMAGETORENTED 500,��0 Eh1$E$.(E� QcctiR$_nce] $ x� Owner's 8 Contractor MEQ EXP (My oneperson) $ 10,000 PERSONAL 8 AOV INJURY s '�,000,000 GEN'L AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE T g 2,000,000 POUCY X JECT LOC pRODUCTS • COMPIOP AGG $ Z,dOO,OOO OTHER A AUTOM081LE LIA61LI7Y COMBINED SINGLE LIM1T i3OOO,OOO Ea acci�eni� $ X ANY AUTO 6E52215 2H/2024 2/112025 BQDI�Y INJURY Le�pe�son 3 OWNED SCHE�UIED AU70S ONLY AU70S BODILY INJURY (Per accident} $ X AUTOS ONLY X AVTOS ONLV P�e08�e DAMAGE $ A X UMBRELLA LIAB X OCCUR EACH OCCURRENCE I$ �,OOO,OOO EXCESSUAB CIAIMS-MADE '�BJSZ2iS YIiIi024 2%iIYOZS AGGREGATE � 5 'I,OOO,OOO oEo X RErENnoks 10,000 PerslAdvert Inj ` 1,000,040 B WORKERS COMPENSATION X I$'[A�E_ f_�_ERH_.I AND EMPLOYERS' LIABILITY Y f N 422�966 2/�J2�24 2l112025 I i,��d,0�� ANY PROPRIETOR(PARTNERlEXEGUTIVE E.L EACH ACCIDENT pFFICERlMEMBEREXC�UDED� N%A + (Mandatory in Nfi) r� L. bl$EASE_EA EMPLOYEEJ $ �,OOO,OflO N yes. descr�be under � ' 4,400,000 DESCRIPTION OF OPERATIONS below I E L. DISEAS6 - POIICY LIMI f I q Installation l 8uild 6C522i5 211l2024 211l2025 Limit 1,000,000 A Equipment Floater 6C52215 211l2024 2Hl2025 Leased 8� Rented 104,OQ0 DESCRIP710N OF OPERATI6NS 7 LOCATIONS 1 VEHICLES (ACORD 101, Additlonal Romarks Schadule, may ba ettached B more apace ie requlred) City of Fort Collins 281 N. College Ave Fort Collins, CO 80524 SHOULD ANY OF THE ASOVE DPSCRI8ED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELNERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AU7HORYZED REPRESENTATIYE ��.',�.�-� ACORD 25 (2016l03) �O 1988-2015 ACORD CQRPORATION. Atl righffi reserved. The ACORD name and logo are registered marks of ACORD 635-9401 �1 A� ORO PCCONST-01 CERTIFICATE OF LIABILITY INSURANCE �ATE �MM/DDlYYYY) 12l2912Q23 THIS CERTIFICATE IS ISSUED AS A MATTER OF iNFORMATIQN ONLY AND CONFERS NO RIGliTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE pOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICkES BELOW. THIS CERTIFICATE OF 1NSURANCE 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 provlsions or be endorsed. If SUBROGATION 1S WANED, subJect to the tertns and condltlons of the policy, certaln policies may require an endorsement. A statement on this ce�tificate does not tonfer rights to the certiflcate holder in Ileu of such endorsementtsl. PRODUCER NFP Property 8 Casualty Services, lnc. PO Box 2127 620 Hinesburg Road South BuNington, V7 05407 iHsuReo PC Constructlon Company 993 Tilley Drive So Bu�lington, VT 05403 524-4652 Berkshire INSURER F : Insurance COVERAGES CERTlFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT ThiE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE PO�ICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITlON OF ANY CONTRACT OR OTHER DOCUMENT WIFH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORbED BV THE POLICIES DESCRIBEb HEREfM IS SUBJEC7 TO AL� THE TERMS EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR 7ypE OF IHSURANCE AODL SUflR pOLICY NUMBER POLICY EFF POLICY EXP V�rc3 A X COMMERCIAL 6ENERAL LU181UTY EACH OCCURRENCE : 2,000,000 CLAIMS-MltiDE I X OCCUR X iOOOOYBOJHZ4i iIiIZOZ4 uuzazs P'�MGE TO RENTED i3OOO,OOO MED E?CP M one erson 5'�� PERSONAL d A�V INJURY 2'Q��}'0�4 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE 4�OOQ�OO{} POLICY�I JEC a ��C PRODl1CT5-COMPIOPAGG 4�00O�OOU OTHER: A AUTOMOBILE LIABILRY COMBINEO SINGLE LIMIT Z,OOU,OOO X ANYAUTO 1000673039241 1l1l2024 iiilZaZrJ BODILV INJURY Per rson S OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY Per eccident HIRED NOk-OWNEO PROPERN AMAGE AUTOS ONIV AUTOS ONLY Per acadenl S A UMBRELIALIA6 X OCCUR EACH OCCURRENCE s S�OOO�OOO X�ccess�ws CLAiMS-MADE 1000588789241 111l2024 1l112025 AGGREGATE 5,000,000 DED RETENTiON S A WORKERS COMPENSATION �( PjR T OTH AIID EMPLOYER$' (.IABILITY Y! H ANY PROPRIETgOW?ARTNERlEXECUTIVE 1000005683 i�i�2�Z4 1J112�25 E.L EACH ACCIDENT 1'�QO'�a� �F;�d ory�i� NH} EXCLUDEO? � N n ra 1,060,OQ0 E.L DISEASE - EA EMPLOVE S �r y-cn, doecribe undor 1�000�080 DESCRIPTION OF OPERATIONS bebw E.L. DISEASE - POLICY LIMIT B Excess Liability 47-XSF-100541-06 7/1/2024 1l1J2025 Each Occurence 10,060,000 B Excess Liability 47-XSF-100541-06 1/1/2024 1!1l2025 Aggregate 10,000,000 DESCRIPTION OF OPERATIONS 1 LOCATIOHS 1 VEHtCLES (ACORp 101, AddHlonsl Remerks Schedule, msy 4e stbehed if mors space Is requlrod� Lieense renewal City of Fort Collins 281 N Colfege Avenue Fo�t Collins, CO 80521-0000 SHOULD ANY OF THE ABOVE OESCRIBED POLICIES BE CANCELLED BEFORE TFIE EXPIRATION DATE THEREOF, NOTICE WILL BE pELNERED IN ACCORDANCE YYITH THE POLICY PROVISIONS. AUlHORIZEO REPRESENTATIYE ��/ v`�•� i ! YC/� ACORD 25 (2016l03) O 1988-2015 ACORD CORPpRATiON. Ali rtghts reserved. The ACORD name and logo are registered marks of ACORD A� U� CERTIFICATE OF LIABILITY INSURANCE DATE�MM/DDIYYYY) 1/26/2024 THIS CERTIFICATE IS ISSUED AS A MA7TER OF INFORMATION aNLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGA7IVELY AMEND, EXTEND OR ALTER THE COVEIL4GE AFfORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NQT CONSTITUTE A CONTRACT BETWEEN THE ISSUING iNSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTAN7: Ii the certifleata holder is an ADD(TIONAL INSURED, the poilcy(ies) must be endoraed. If SUBROGATION IS WAIVEp, subject to the tenns and conditlons of the pollcy, certain polieies may requlre an endorsement. A statement on this certlfleata does not confer rights to tha certifteate holder fn lieu of such endonemant{s�, PRODUCER N�E: Repee MCRljR101�d Exing-Leavitt Inauranca Aqency, Inc. PHONE ,{970}679-7344 � Hp: (856��S6-f180 5689 McWhinney Bivd. E��&y.renee-mcreynolds@lenvitt.com LOVe�dll� INSURED L i M Entarprises, Inc. P O Box W 735 E. High�ray 55 Berthoud COVERAGES lN3URER 9 AFFORDING COVERAGE HAIC i CO 80538 IN$UftERA:Sl1@Ct1V@ Insuranca Grou Inc. 12572 iHsurtert s: Pinnacol Asauranco 41190 iksuaeac:Caeitol Svecialtv inaurance CO 80513 CERTIFICATE NUMBER:24-25 QRG REVISION NUMBER: THI5 IS TO CERTIFY THAT THE POLICIES OF iNSURANCE LISTEO BELOW HAVE BEEN ISSUED TO 7HE INSURED NAMEO ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFIGATE MAY BE ISSUEO OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICiES DESCRIBED HEftEIN IS SUBJECT TO ALL7FiE TERMS, EXCLUSIONSAND CONpITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAIO CLAIMS. INSR TypE OF INSUMItCE �DL SUBR p01JCV NUMBER M�DY EFP 1P�CV El(P UKR, LTR � X COMMERCLLLOENERAiWBILITY EACHOCCURRENCE s 1,000,000 A CLAIMSMADE �X DCCUR �' S00,000 PREMI ES Ea ocwrrence S X B1kY Rddl Insurads X S 2302680 2/1/202� 2/1/2023 MED E?(P My one paroon) = I5, 000 X Blkt Nliv�r BubYogati0e PERSONAL dADV INJURY s 1,OOO,Q00 GENLAGGREGATELIMITAPPLIESPER: GENERALAGGREGA7E { 2,000,000 POLICY � jE�T � LOC PRODUCTS•COMPlOPAGG S 2.000,000 O7HER: s AIJfOMOBILE LUIBILRY COMBINED SINGLE LIMIT S 1, 000, 000 Ee saide 1 A X qNyq�p BODILY INJURY (Per perea�) S ALL OWNE� SCNEDULED X g 2302660 2/1/20Z1 2/1/Y025 80DIlY �NJURY {Per saodentl S AUTOS AUTOS NON-OWNED PROPERTY DAMAGE x HIREDAUTOS x AUTOS Per acddent s X 6IXl WOS X 61k1 AOdi Meureda M�� S X UMBR8l4AL1A8 OCCUR �ollon !om ov�c AL/CL1EL EACH OCCURRENCC S 5 000 000 A ExCES3 uwe CWMSMADE AGGREGATE S 5 000 000 DEO X RETENTION f 0 $ 2302880 2/1/202� 2/1/2025 s WORNERS COMPHNSATION Incl 81kt Kaiv�r Hubeoqation x PER ERH AND EMPLOYERS' LUBILT! Y f N ANVPfiOPR1ETORlPARTNERlE?fECUTNE N!A E.l EACHACCIDENT S 1 000 000 OFFICERJMEMBER EXCLVDEO4 � B (M�nd�toryinNH) �188129 1/1/20i1 1/1/2025 E.L DISEASE-EAEMPLOYEE i 1 000 000 If yes, desaibe u�der O£SCRIPTION OG OPERATIONS Eelow E.� DISFA5E - POLICY lIM1T 3 1 OUO 000 C Contzactors' Pollution N20190041-06 1/1/2o2a 1/1/2o2s S2Moa�t2�r��e9are A Installation Fltr-$1,000,000 S 2303980 2/1/202a 2/1/2025 �msedlRencedEQulpStSo.00O OE6CRIPTiOt1 OF OPERATIOM31 LOCAT10N8! VEHICLES (ACORO 101, Addftlonal R�maAcs Sch�dut�, may M�tt�cMd H mon �pau is nqulnd) re: BID 8095 Waed Cutting 6 Rubbiah Ramoval; Certificate holder, ite officera, aqenta and saq�loyeee are named sdditional ineured aa respetts both ganaral and auto liability policias. The ineurance evidenead by thia certificate Mill not reduce coveraqe or limite and xill not be cancelled axcapt after thirty (30} days .rritten notice has been rece3ved by the certificate holder. CERTIFICATE NOLDER City of Fort Collins Attn: Purchasinq Dept P Q Hox 580 Fort Collins, CO 80522 CANCELLATION SHOULD ANY OF TFIE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE NfILL BE DELIVERED IN ACCORDANCE WffH 7NH POLICY PROVISIONS. AUTHORQED REARESENTATIVE MCReynolds/LAEW[N ACORD 25 (2014101) INS025 �zoiao>> p 1888-2014 AC� The ACORD name and logo are registe►ed marks of ACORD DA7E (MMIDD/YYY`� A�� o� CERTIFICATE OF LIABILITY INSURANCE 1/26J2024 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIG}4TS UPON THE CERTIFICATE HOLDER. THlS CERTIFICATE DOE$ NpT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDEb BY "I'HE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES N07 CONSTITUTE A CONTRACT BEIWEEN THE ISSUING INSURER(S), AUTHdRIZEd REPRESENTATIVE OR PRODUCER, pND THE CERTIFICATE HOLDER. IMPORTANT: !f the certificate hoider la an ADDITIONAL INSURED, the poliey{les} muat be endo►sed. If SUBROGATION IS WAIVEP, subJect to the terms and eondittons of the pollcy, certaln pollcfes may require an endorsement. A statement on this certiflcate does not conter rights to the certificate holder in lieu of such endorsement(s). artooucert N�ME: Renee McReynolde Erinq-Leavitt insurance Aqency, Inc. PHOHE .(970)679-7344 � No; �ecc��ss-ciea 5b89 McWhinney Blvd. ��Sg:renee-mcreynolda@ledvitt.com Loveland INSURED L i M Enterpriaes, InC. P O Box W 735 E. High..ay 56 Berthoud COVERAGES CO 80538 iNsuaER E : CO AOS13 INSURERF: CERTIFICATE NUMBER:24-25 ptcG REVISION NUMBER: 2 TFi15 IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED A$OVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANpINGANY REQUIREMENT, TERM OR CONDITION OF ANY CON-iRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY B£ ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL TFiE TERMS, EXCLUSIONS AND CONDITIONS OF SUCfi POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TypE pF INSURANCE �DL UB pOLICY NUMBER M WpLY EFF M UCY E3(P UNR9 LTR X COMMERCULL GENERAL LIABILRY EACH OCCURRENCE s 1� 000, 000 A CLAtMS-MADE ❑X OCCUR pREMISES Ea oocurrence S 500, 000 X Blkt ]1dd1 Insureds X S 2302880 2/1/202� 2/1/2025 MED EXP (M one peraon) f 15, 000 x Blkt Waiv�r Subrogation PERSOw�I. 6 aDV tNJURY S 1, 000, 000 GENIAGGREGAT£LIMITAPPLIESPER: GENERALAGGREGATE = 2,000,000 POLICY � jE�T � LOC PROOUCTS • COMPIQP AGG { 2, 000 , 000 OTHER: s AUTOYOBILE LIABIUTY COMBINED SINGLE LtMIT S 1, 000 , 000 Ee aafdenl A %� ANY AUTO BODILY INJURY (Per peroan) S A!L OVJNEO SCHEDULEO X g 2;02BB0 2/1/20i� 2/1/2025 BODILV INJURY (Per e,ccidenl) S AUTOS AUTOS NON-OWNED PROPERTY �AMAGE x HIREOAUTpS x AUTOS Pm accident s x BIMWOS 7[ 81MA�tldllneweUe �� q S X UMBRELLALIAB pCCUR Follo� Pozm ov�r 1�L/GL/YL EACH OCCURRENCE f 5 000 000 A E7(CESS UAB CLOJMS-MADE AGGREGATE f S 000 000 DED X RETENTION 0 S 2302660 2/1/2021 2/1/2025 f WORI(ER9 CONPENSATION inel Blkt M+1v�r Suhroqation X PER TH- ANDEMPLOYER$'WBILfTY Y�N A ER ANY PFiOPRtEfOR/PARTNEWE%ECUTIVE N �A E.L. EACH ACCI�EN7 f 1 000 000 OFFICERlMEMBER FJ(CLVDED7 N❑ H (M�nd�toryinNH) �168429 1/1/702� 1/1/2025 E.L.DISEASE-EAEMPLOYEE f 1 000 000 If yes, desaibe under DESCRIPTION OF OPERATION5 be10w E.L. 91SEASE - POLICY LIMIT i 1 000 000 C Contractors' Pollutioa iv10 19 0 011-0 6 i/i/sos� i/i/so2s izMuomsz�i�ey.re A inatallation Flts-$1�000,000 8 2303880 2/1/IO2� 2/1/2025 �ssaedfRentedEqulpf150.0pp DESCRIPTION OF OPERAT10N3 ! LOCAT10N8 ! VEHICLE3 (ACORO 101, AdQHIonN R�maAes Seh�dul�, rtwy M�tt�eMd if mon sp�u I� nqulnd� Cortificate holder, its officers, aqente and amploysea ara naared additional inaurad aa respecta both genaral and auto liability policiee. CERTIFICATE HOtDER City of Fort Collins P 0 Box 580 Eort Collins, CO 80522 GANGELLAT[pN 5HOUL0 ANY OF THE ABOVE DESCRtBED POLICIES BE CANCfLLED BEFORE THE EXPlRATION pATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WfTH THE POLICY PROVISIONS. AU7HOfiIZEO REPRESENTATNE McReynolds/LAEWiN ACORD 25 (2614I01) INS025 {zo�ao�� 1988-2014 ACORD CORPORATION. All rights reservad. The ACORD name and logo are reglstered markg of ACORD .�� NOCOHYD-01 AcoRo CERTIFICATE OF LIABILITY INSURANCE DATE�MMIDOlYYYY) ��" 1/22/2024 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RfGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMENQ, EXTEND OR Al7ER THE COVERAGE AFFORDED BY THE POLICIES BELOW, THIS CERTIFICATE pF INSURANCE OOES 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 dnd conditions of the policy, ce�tain policies may require an endorsement. A statement on this certificate does not confer ri�hts to the certificate holder in lieu of such endorsement(s). _ ___ PRODUCER �A�T Scott Runyan Renaissancelnsurance Group PHONE Fnx PO Box 478 �nrc. No, e��: (970) 236-8272 �nrc, No�: windsor, co eosso A"'^'� srun an reninsurance.com o��ss; Y � INSURER(S� AFFORDING COVERAGE , NAfC p iHsuaeR a; Employers Mutual Casuaity Co _ 21415 INSURED INSURER B: P��111dCOI ASSUidIIC@ 41190 NOCO Hydronics 8 Plumbing LLC INSURERC: � 3655 Canal Or, Unit B IMSURER D: Fort Collins, CO 80524 � IHSURER E : � INSURER F : COVERAGES CERTlFICA7E NUMBER: � REVISlON NUMBER: TH1S IS TO CERTIFY THAT THE PO.ICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSUREO fJAMED ABOVE FOR THE POLICY PERI00 INDICATED. NOTWITHSTANOING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE iSSUEO OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES OESCRIBED HERFIN IS SUBJECT TO ALL THE TERMS EXCLlJSIONS AND CONDITIONS OF SI.CH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUGED BY PAIO CLAIMS. INSR rypE OF IHSURANCE ADDL SUBR pO11CY NUMBER POLICY EFF POLICY E%P LIMITS LTR � [NSD YYVD fMYI�DDfYYYYY IMN1DQi7YYY) A X COMMERCIAL GENERAt LIABIUTY EACH OCCURRENCE s 1,000,000 � __ CLAIMSMAp� X OCCUR 6D29447 �/25�2�24 1f25l2025 OAMAGETORENTED 500,�0� � F'iitNlStS{Ea�cruusnfql . � MED EXP iMy Ong p@i5pn� 5 �fl�OOO � PERSONAL S ADV INJURY S �,��d,�� GEN'L AGGREGATE LIMIT APPUES PER GENERAL AGGREGATE s 2,OOfl�OOO POLICY X �E�T LOC PRODUCTS - Ct7MPlOP AGG S 2,000�000 ra -� ----- - -- _. . - ' AUTOMOBILE LIABILITY X ANVAUTO 6E29447 � � OWNED $CIiEDULEO AUTOS ONLY AUTOS HIRED NON•OWNED , , AUiOS ONIY AUTOS ONLY A X UMBRELLA LIAB X OCCUR � EXCE$$ L1A6 CLAIMS-MApE 6J29447 DED X RETENTiONS �O�OOO -� - ---- —' --'— ' B WORKERSCOMPENSATON AND EMPLOYERS' LIABILITY Y i N A�N�YPROPF2tETOR/PARTNEWFafECUTIVE 422S�O� (MandatoryFi� BE � EXCLUDEO? Y N 1 A NH Ilves.desc�De under �COMBINEDSINGLEtIM1T I 'I�OOO�OOO ltd iGGCQ�U � ± . ��25�2�24 ��2S�Z�2$ P!�pI;YINJURY Pwr�a�sonl ,S BODI�Y INJURY ;Per acdtlenl) � PRQPERTYpAMAGE �PeraccbenlJ . S S EACH OCCURRENCE ' s �AOU,OOO 1f2512O24 1125/2025 qGGREcaTE _� 1,000,000 . . . '� - X � PER � OTH- stn�u�� + 211/2024 2l1/2025 EL EACHACCIDENT j 1,000,000 E L �ISEASE - EA EMPLOYEF� S �,OOO,OOO e � CISCASC - Pa_ICY _IMIT S 1,006,000 fIOH OF OPERATIONS 7 LOCATIONS % YEHILLES (ACORD 707, AddRlonal Remarks Schedule, may be attached iF moro space la required) to policy forms, conditions, deflnitiona and ezclusiona. City of Fort Collins PO Box 580 FoA Collins, CO 80522-0580 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE 1MLL BE DELIVERED IN ACCORDANCE WfTH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE O,�`-'�^.'.,a.� C��-�D�.�'�.. ACORD 25 (2016l03) � 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered ma►ks of ACORD ,acoRO� CERTIFICATE OF LIABILITY INSURANCE DATE(MM��DD�YYYV) �,r-- O1/Q3/2024 THIS CERTIFICATE IS IS3UED AS A MATTER OF INFORMATTON ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICA7E HOLDER. THIS CERTIFICATE DQES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COV�RAGE AFFOROED BY THE POLICtES BEL�W. TH15 CERTIFICATE OF INSURANCE DOES N07 CONS717UYE A CONTRAC'F BE7WEEN THE ISSUING ItJSURER(S), AUTHORlTED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICA7� NOLDER. IMPORTANT: Ii the cerilTicate holder is an ADDITfONAL INSUREQ, the policy{ies} must have ADGITIONAL INSURED provisions or be endorsed. lf SUBROGATION IS WAIVED, subJecl Ea ihe terms and conditions of the policy, certafn pollciss may require an endorsement. A statement on this certiHcate does not confer ri hts to the certificate holder in Ileu of such endorsement s). PROOUCER CQN7ACT qi2lis Towara Natson CortificatQ Contor NAME: Willls Torers iPetaon Insurence Servica• West, Inc, pl10NE 1-877-945-7378 FAX 1-BBB-467-2378 c/o 26 Century Blvd NC No: P.O. Box 30519i A DRESS: certificatee@wil]is.com Nw�hV171f�. TN �7>7fSaiai ttaa INSURED Hnrsocke I,LC 2162 N Grova Pfcxy, Ste 100 fl�asant Grovs, UT 84052 TB2-641-4�6161-053 COVERAGES CERTIFICATE NUMBER: wsz3seaes REVISION NUMBER: THIS IS TO CERTlFY THAT THE POLICIES OF INSURANCE LISTEp BELOW HAVE BEEN ESSUED TQ THE INSURED NAMED ABOVE FOR THE POLICY PERIOb INDICATED. NOTWITHSTANDING ANY REQUIHEMEN7, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFOADEO BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDfTIONS OF SUCH PQUCIES LiMITS SHQWN MAY HAVE F3EEN REDUCED BY PAID CLAIMS. NSR TYPE OF WSURANCE ��TT�IaDDI SUBR T pOLICY NUMBER I MM�C�YY M�M�D� D.Y/YYY LIIATS iTR X� COM/AERCIAL GENERAI LIABIL{7Y I�CH OCCURRENCE $ 2, Q00, 00 � � CLAIMS-I.fADE x OCCUR I ' 1, 040, 00 PREMISES�Ea acturrence 3 � GEN'L AGGREGATE LIMiT APPLiES PER X ' POLICY �RO• LOC JEGT AUTOMOBfLE UABILITY X AtJY AUTO B OWNED SCHEDULEO � AUTOS ONLY AUTOS HIRED NON QWNEp AUTOS ONLY � AUTOS QN_Y �( UMBRELLA LIAB X O�CUR C � EXCESS LIA9 CLAIMS MAOE I DED I I RETENTIONS WORKERS COlAPENSATION AND EMPLOYEAS' LIABILtri Y� N B �ANVPHOPHlETOft'PARTNER'EXECUT{VE Q �OFFICER�MEMB£REXCLUDED� N'A (Mendelory in HH) II ve4. f165crib@ undB� D Prof�asionnl Lieb 1nc1 Pollutlon AS7-641-046161-003 1►UC 8344746-00 NC7-641-4C6161-063 lNSURER(S} AFFORpIHG COVERAGE NAtC B If:SURERA: Liberty Mutual Fire Insurence Company 23035 II�tSURER6: Liberty inavrancn Corporntion I 42a04 iMSUREqG: �arican Guarantaa and Liability Inaurancel 26247 INSURERD: �lled World Surplue Linas Inaurance CouspaT 24319 INSURER E : I INSURER F : __.. T _ - ----�--• MED EXP (An one person� S 12/31/2023 12/31/Z024I PERSONAL8AOYiNJURY S GENeRAI.AGGREGATE $ I PRODUCTS - COMP�OP AGG S IS COMBINED SlNGLE LIMIi s [a acatlonll ��_ BODILV INJURY (Per persony S 12/31/2023 12/31/202� BOOILYItJJl1RY(Peractident) $ PROPER7YDAMAGE $ (Per accident) $ 25,00 2,000,00 6,ODO,DO A,000,00 5,600,00 ,EACNOCCURRENCE �$ 10,000,00 12/31/2023 12/31/202C AGGREGATE Ig 10,000,00 IS f X S7ATUTE I ERH E.L. EAGH ACCIDENT g 1, Q00, 00 12/31/2023 12/32/202d � E.L. DISEASE EA EMPLQYEE� 3 1, Q00, 00 E.L. DiSEASE � POLtCY LIMiT $ 1, 000, 00 0313-8987 07/O1/2023 D7/02/202< Eech Clain Limit �$S,OOO,OOD Policy Aqqreqete �55,000,000 OESCRIPTION OF OAEHATIONS ' LOCATIONS 1 VEHiCLES (ACORD 101, Addllfonal Remarks Schedule, may be attached if mo�e spate is �equked) CERTIFICATE HOLDER SHOULD ANY OF TriE A80VE DESCRIBED POUCIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTIGE WILL BE DELIVERED IN ACCORDANGE WITHTHE POLICY PROV1S10NS. City of Fort Collina AUTHORIZED REPRESENTATtVE Purchasing Division p0 Box 580 /'� �, 8ort Collins, CO 80522 L__y � 1968-2016 ACORD CORPORATION. All rights reserved. ACORD 25 (201fi/03} The ACORD rtame and fogo are registered marks of ACORO sn zn: 25224I99 �t�H� 3267472 CANCELLATIQN 59i4 1 ' Uf ! , � '��R'� CERTIFICATE OF LIABILITY INSURANCE onre iMM�oorvrir� 0117512024 THIS CER7IFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RiONTS UPON THE CERTIFICRTE HOLDER. THIS CERTIFICATE DOES NOT AFFIRiNATIVELY OR NEOATIVELY AMEND, D(TEHD OR ALTER THE COVER/lOE AFFORDED BY THE POUCiES BELOW. THIS CERTIFICATE OF INSURANCE DOES N07 COHSTITUTE A CONTRAC7 BETVYEEN TIiE ISSUINO INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certiflcate holder Is an ADDITIONAL lNSURED, the pdicy(fes) �rust have ADDITIONAL INSURED pravislons or 6e endnrsed. If SUBROOATION IS WAIVED, subject to the tams and condilions o( !he pollcy, ceRaln pollcles may roquire an efxlorsement. A statement on ih(s cerliHeate does not ooMar ri�ts to the certi}icate hdder in Ifeu of such endorsemeretisl. PRODUCER FEDERATED MUTUALINSURANCECOMPANY HOME OFFICE: P.O. BOX 328 OWATONNA, MN 55060 INSUREO DNS4 FREEDOM LLC 10100 TWENN MILE RD PARKER, CO 80134bi5� C��ES CERTIFlCATE NUMBER: t3 CUENT CONTACT CENTER INSURERS AFFORDIHO COI iHsurten n:FEDERATED MUTUAL INSU 4�-�5-7 INSUREH B: INSUREH C: iNsunEa o: INSUREN E: REVISION NllMBER: 0 73435 TH1S IS TO CERTlFY THAT TNE POLICIES OF INSURANCE LIS7ED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLlCY PERiOD INDICATED NO7WITriSTANDING AkY REQUTAEMENT. TERM OR CONDITION OF pNY CONTRAC7 OR OTHER DOCUMENT W TH RESPEC7 TO WHICH TH S CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POUCIES DESCRIBED NEREIN IS SUBJECT TO ALL TME TERMS FJCCLVSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CIAIMS. tN I TYPE OF IHSURPNCE '�� BR POLICY NUMBfR Y EFF POLICY E%P LIM�TS COMMFRCIAL 6ENERPI LIABfLITY EACM OCCURRENCE s'I,000,000 CLP1M5•MODE ❑X OCCUR M7AGE i0 EMTED PREMI8E8 =�� 0 x BVSiNF65 ONRI£R'S LIABILITY MED EKP (My one Oenm) A N N 1883T74 01/09f2024 01108l2025 pERSONn18 MVl11JURY �1,000,000. GENL AGOREGATE LIMIT APPLIES PEfl� GG OOO O X POLICY �ECa O LOC PRODUGTB 8 COMPlOP A60 �I' ,OOO,OOO OTHER: AUTOMOBILE LIA8ILITY E�M9��E�p gINOLE L1MIT �� Q� �p X ANYAUiO BOOILV INJURY IPer Pe�aa� A CWNEDAUiOSONLY AUTOSULED N N 1883775 �1/(18l2�4 01l08/2025 BOUILYIHJURY�P�r/kcidmd HIRED AUTOS QYLY AUT� O LY ��Rfa pM1A6E x UM9RELLA LUlB x OCCUR EPCH OCCURRENCE S1,OOO,OOO A EXCFSSLIAB 0.AIAUSfiAADE N N 7883776 �l/�i1024 01108/2a25 ACCRECATE q�,�,� DED REiENTICN WORKER! COMPENSATION ANU EMPLOYERS' LIABILI7Y y� X PER 6TATU7E TNER ANY PROPRIETOR/PARYNERI E%ECUTIVE E.L EAGH ACCIDENT ESOO,OOO q ar�cEwMEMBERE�CLUOEai N!A N 1883T77 O1lOB/2024 01/OB/ZQ2S (MenA�tory In NH) E.l DISEAS£ EA EMPLOYEE �SOO,OOD �li Yef, QescrlDe VIAe! �DESCRIPTION Of OPfRATl0713 b�low E.l DISEAS£ • POLICY lIM1T E$�,� OESCRIPTIOH OF OPERATIONO 1 LOCATION41 VEHICLfS �ACORD 101, Addi6aW q�muis Sd�eAule, m�r Ue dhd�ed il mora sp�ce if rpuinEJ CERTIFICATE HOLDER CANCELLATION 436�35-7 CITY OF FORT COLLINS 281 N CO�I.EGE AVE FORT COLLIMS, CO B0524-2404 13 0 I SHOULD ANY OF 7HE ABOVE DESCRIBED POLJCIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WiLL 8E DELIVERED IN ACCORDNiCE WITH THE POUCY PROVISIONS. Al1THOq1iEDREPRESEH7ATIVE �/�l'J/u J� Jj �"""` t l !/ 4/ I�11. 507�46-466i O i9�8-2015 ACORD CORPORATION. All rl�ttf reserved. ACORD 25 �2D16l03} The ACORO name and logo ara registered marks ot ACpRD DATE �MM+ODNYYY) A�RQ� CERTlFICATE �F LIABILITY INSURANCE i1412024 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATI4N ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. TiiIS CERTIFlCAiE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORbED BY THE POLICIES BELOW. THIS CERTEFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORI2EQ REPRESENTATtVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If tMe certificate holder Is an ADDItIONAL IIJ5URED, the policy(les) must have ADOITIONAL INSUREQ provisions or be endorsed. If SUBROGATION IS WAIVED, subJect to the terms and conditEons of the pollcy, certaln pollcies may require an endorsement. A statement on this certiflcate does not conter rf hts to the certlticate hoider in Ileu of such endorsement(s). PRODUCER Np�,M� IMA 1Nchita Team tMA, Inc. - Wichita PHONE , 316-267-9lli ac No: PO Box 2992 WiChita KS 67201 aooR�ss: certs(c�imacorp com INSUREb United Energy Corporation PO Box 837 Bismarck ND 58502 t.!cense#: PG-1210733� iNsuReRn: Ohio Securi UNITENE Ot� _-��_ INSUHEq D : AFFORDING r 15792 15911 _ C�VERAGES CERTIFICATE NUMBER: 128868b1o1 REVISION NUMBER: THIS 1S TO CER7IFY THAT THE POLICIES OF INSURANCE LiSTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLiCY PERIOD IN�ICATEp. NOTWITHSTANDING ANY AEQUIREMENT, TERM OR CONOITION OF ANY COfJTRACT OR OTH£R DOCUMENT WiTH RESPECT TO WHICH TkIS CERTIFICATE MAY $E iSSUED OR MAV PERTAIN, THE INSURANCE AFFOROED BY iHE POLIGlES DESCRISED HEREIN IS $UB.IECT TO AE.L THE TERMS, EXCLUSIQNS ANp CONUITIONS OF SUCH POLiClES. LIMITS SHOWN MAY HAVE BEEN ftEDUCED BY PAID CLAIMS. ��7pry TV?EOFINSURANCE aNDDI$WYD POIICYNUMBER �A�M7uD�y1�Y I M�MrD��MI P I LIMTS 8 X COMMERCIALGENERAtLIABILI'fY Y Y USGL1512549 5f31l2023 5l31i1024 £ACHOCCURRENCE 51.000.000 ' CIAIMS•MADE X OCCUR I PREMISES fEa ocairroncnJ_ 5 50 000 ' MED EXP (My oee persan) 5 5,000 � � PERSONAL & ADV INJURY S 1.000.000 GEN'L AGQAEGATE LIb11T APPLIES PER GENEHAL AGGREGA7E i 2,U00,000 %� POLICV �E � LOC � l PFiODUCTS COMP.,�OP AGG S 2,000 000 OTHER � E A AUT�IAOBILE UABIUTY Y Y $AS642D7718 11112024 1/1/2025 COMBINED SINGLE UMIT y �,p00.000 1 ANY AUiO (Ea_acadeni) BODILY IN,IURY {Per person) $ OW�lEO X SCHEDULED BpDILY IWURY (Per acadent) S AUTOS ONLY AUTOS X I HIHEU x NONOWNFO PROPER7YpAMAGE $ AUTOS ONLY AUTOS ONLY {Per accident I � Ib UMBREU,ALIAB � �CUR EACHOCCURRENCE S EXCESS LlAB CWM5�MAOE A(3GREGATE S I �ED 1 I AETENTION3 I 5 C WORKERSCOMPENSATiON 1' AMWC409301 111l2024 1/1/2025 X AND EhtPLOYERS' LIABILITY Y r N STA�UTE EpH ANYPAOPRIE70WPQRTNEWEXECUTIVE � N� A E.i. EACH ACCI�ENT S i.000.000 OFFIC Efl�ME MB E R ERCL UDE �? (Mandetory In NH) E.t. pISEASE � EA EMPLOYEE 5 1,000,000 !I yos. ci�sci�be under OESCRIP710N OF OPERAiIONS bebw E.l.. DISEASE • POLICY LIMIT S 1,DOD,000 OESCAIPTION pF OPERATIONS � LOCATIONS / VEHICLES (ACORD 101. Additionel Re�rfarks Scbedule, may be etlached 11 more spete is tequked) Certificate Holder and aq other parties tequired by the contract are included as Addihonal Insured on the General Liability and Automobile l.iability Policies, if required by v�ntten contract or agreement, sub�ect to ttie policy terms and condiUons A Waiver of Subrogation is provided in favor of Certificate Holder and all oSher parties required by the contract on the Generaf Liability, Automobde Liability and Workers Compensalion Policies, if requtred by written contract or agreement, subject to the policy terms and condi4ons CERTIFICATE SHOULO ANY OF THE ABOVE bESCRIHEP POUCIES B E CANCELLED BEFORE THE El(PIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WFTH 7HE PULICY PROVISiONS. C!ry of Fort Collins PO Box 580 Fort Collins CO 80522 ACORD 25 {2Q16/03) AU7HOR3ZE� REPRESENTATIYE ��- � 1888-2015 ACORD COftPORATlpN. All rights rsserved. The ACORD name and logo are reglstered marks of ACORD 8869: 2 ' oi �� ACORO �� BUSCINC-01 CERTIFICATE OF LlABILITY INSURANCE DATE (MMlDDIYYYY) 1(1212024 THIS CERTIFICATE IS lSSUEO AS A MATTER OF INFORMATION ONLY AND CONFERS NO RiGHTS UPON 7HE CERTIFICATE HOLDER. TFiIS CERTIFICATE DpES 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 7HE ISSUING INSURER{S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CER7IFICATE 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 certiticate does not confer riahts to the certificate holder in lieu of such endorsementisl. PRODUCER American Highways Ins. Agency 3250 Interstate Dnve Etichfield, OH 44286 INSURED Busco, Inc. dba Arrow Stage Lines 4220 South 52nd St. Omaha, NE 68117 �„ON�ACT hAh1E: aHO." o, Exn: (800} 935-2442 _�ac, No�_(330) 659-8912 E-RRAIL ahia.hi hwa service natl.com � ,_aQogess• 9 Y @ INSURER(Sj AFFORDING COVERAGE NAIC i I �►+suReR n� National Interstate Insurance Company 32620_ I INSURER B : I I INSURER C : �. INSURER D : COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY 7HAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMEb ABOVE FOR THE POLICY PERIOd INDICATED. NOTWITHSTANDING ANY RE�UIREMENT TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCU��4ENT WIiH RESPECT TO WHICH THIS CERTlFICATE MAY BE ISSUED OR MAY PERTAW, THE IN�URANC'L AFFORDED SY THE POLICIES DESCRIBED HEREIN IS SUBJcCT TO A�L iHE TERMS. EXCLUSIONS AND CONDITIONS OF St1CH POLICIES LIMITS SHOWN MAY HAVE BEEN REDUCEO BY PAID CLAIMS. MSR AODL�SUBRl POLICY EFF POl.ICY EXP FYPE OF INSURANCE i POUCY NUMBER � I LIMITS � __ IN50I W�¢ { (MMl�D'YYYYI IMM7p�,!YY1Yj A X GOMMERClAL GENERAL LIA8ILITY f �`l Cv+IMS-MAOE X OCGUR X X XPP1119490-21 211l2024 21112025 OCGURRENCE MEO F,xP {Any one person)_ PERS:�NAL 8 ADV INJURY L AGGREGATE LIMIT APf'IIES PER. POUCY j��7 LCC A AUTOM6811E LIABILITY X ANY AUTO OWNED r Al1TOS ONLY I X AUTOS ONLY I_' UMBRELLA LIAB El(CESS LIAB SCHEDULED AUTOS AU OS ONI.� OCCUR CLAIMS-MApE I DED I I RETENTION $ I WORKERS COMPENSATION AND EMPLOYERS' LIABILITY y! N� ANY PROPRI£TORlPARTNEFUEXECUTIVE - ' �FFICEWMEMBEREXCLl3DED7 �N1A Mandatory in NH} ltses.tlescnba under X I X XPP1119496-21 1119490•20 2/112024 I 2/112025 21112024 I 2/1l2025 PROOIJCTS - EiODILY INJURY (Per pen BODII.Y INJURY �;Per acc PROFER7Y DAMAGE ACii":CCURRENCE DESCRIPTION OF OPERATIONS ! LOCATIONS ! VEHICLES (ACORD 101, Additlonal Remarks Schedule, may be attached Yf more space Is requlred) Physical Damage Deductibles: a20,000 per charter bus (> 29 PAXj - Comprehenslve, Colllsion 55,000 per van, limo, school, transit - Comprehensive, 310,000 Collision E2,500 per pplservlce for ComprehensivelCollision Sexual and Abuse 31,000,066 each claiml$1,000,000 aggregate E ATTACHED ACORD 101 y 5,000,000 $ 2�fl,��0 $ 5,000 $ $,Q�fl,00� � S��Ofl�� 5,000,000 s,000,oao SHOULD ANY OF THE ABOVE DESCRIBED POLtCIES BE CANCELLEU BEFORE Cit of Peoria Materials Mana ement - Q19-02 THE EXPIRATION DATE THEREOF, NO710E wll�L 6E DELIVERED IN Y 9 ACCORDANCE WITH THE POLICY PROVISIOMS. 9875 N. 85th Ave. 2nd Floor Peoria, AZ 85345 AUTHORIZED REPRESENTATIVE � G rh—_ � ACORD 25 (2016103) OO 1988-2075 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD /� A�ORO AGENCY merican Highways Ins. Agency POUCY NUMBER � EE PAGE 1 CARRIER EE PAGE 1 ADDITIONAL REMARKS AGENCY CUSTOMER I0: BUSCINC-01 LpC #: ADD1T14NAL REMARKS SCHEDULE NCVAXM Page 1 of 1 NAMEDINSURED Busco, Inc. dba Arrow Stage Lines 4220 South 52nd St. Omaha, NE 68117 T NAIC CODE VSEE P 'I EFFECTIVE DATE: � THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: %+COR� 25 FORM TITLE: CertiTicate of Uahility Insurance Destription of OperationslLocationsNehicles: The City of Peoria, its representatives, directors, officers, and employees are named as additional insured on the auto liability and general liability policies pursuant to the terms and conditions of the policy; primary and non-contributory coverage sha11 apply to the auto liability and general liability if a contratt specifically requires that this insurance be primary; a waiver of subrogation applies on the auto liability and general Ilability when required by a written contract. The company will mail the certificate holder written notice of cancellation. If possible, the notice will be mailed at least 30 days, except for cancellation of non-payment of premium, which will be mailed according to the policy provisions, prior to the effective date of the cancellation. Any provision that is in conflict with a statute or rule is hereby amended to conform to that statute or rule. ACORD 101 (2008101) C� 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORI} .�� Buscirvc-o� ACG7R�' CERTIFiCATE OF LIABILITY tNSURANCE DATE�MMIDDJYYYY) `�� 1/12/2024 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPpN THE CERTIFICATE HOLDER. THIS CERTIFIGATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLfCIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTfTUTE A CON'iRACT BETWEEN THE ISSl71NG INSURER(S}, AUTHORIZED REPRESENTATIVE OR PRODUC�R, AND THE CER7IFICATE HOLDER. IMPORiANT: If the ce�tificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION 1S WAIVED, subject to the terms and conditions of the policy, ceRain policies may require an endorsement. A statement on this ce�tificate does not confer rights to the certificate holder in lieu of such endorsement{s1. PRODUCER American Highways Ins. Agency 3250 Interstate Drive Richfield, OH 44286 INSURED Busco, Inc. dba Arrow Stage Lines 4220 South 52nd St. Omaha, NE 68117 COVERAGE$ CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT 7HE POLIC�ES OF INSURANC� LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY i2EQUIREMEN7. 7ERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUEO OR MAY PERTAIN THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN !S SUBJECT TO ALL THE TERMS EXCLUSIONS AND CONDITIONS OF SUCH POLICiES LIMITS SHOWN MAY HAVE BEEN REDUCEO BY PAID CLAIMS. INSR AODI(SUBR�., POLICY EFf POLICY EXP LTR TYPEOFfNSURANCE I��,�p,,,�� POi1CYNUMBER �.(��ipQ,�YY� llAMlDpm•yY� LIMITS A �( COMMERCIAL GENERAL LIABILITY I II I CfAIMS MADE X O�:CUR � GEN'L AGGREGATE LIM1T APPUES PER X POLICY P��T LOC X XPP1119490-21 ti�nosa srusoss A AUTOMOBILE LIABILITY � X � ANY AUTO 1 OWNED SCHEDULED .. AUTOS ONLY AUTOS µ X, AU �� ONLY X-. A�TOS ONL� A I UMBRELLA LIAB X OCCUR )( �EXCESS LfAB ! CWM$-A� I DEO � � RETBNTION S x XPP1119490-21 XEX1119490-20 ...... �.e. �... �.... �....,.�.. . Y f N ANY PROPRIETORlPARTNERIEXECUTIVE Q_FFICERfMEbSBER E:(CLUDED? N 1 A �Mandalary in NH) 2/1l2024 21112025 2l1/2b24 2/1/2025 EAGH OCCURRENCE , $ DAMAGE TO RENTED . P!?�MI$�S.(E8 OGGu!�@�GBi . $ MED_EXP {Any one person � S PERSONAL 8 AOV INJURY $ GEN[RALAGGREGATE S PROpUCTS - COMP/OP AGG S S COMBINED SiNGLE LIMIT 1E3.�G.LQC�1; . $ BODILYINJURYiPerper50n $ BODILY INJURY � Per accident; �$ PROPERN OAMAGE �Peraccid^nti , $ iCRIPTION OF OPERATIONS 1 LOCATIONS I VEHICLES (ACORD 101, Addltlonal Ramarka Schedule, may be aHached if more apace fs requlred) �sical Damage Deductibles: ,000 per charter bus (> 29 PAX} - Comprehensive, Collision 100 per van, limo, school, transit - Comprehensive, 510,000 Collision i00 per pplservice for ComprehensivelCollision and Abuse S1,aoa,000 each clalmlSl,OOO,UOU aggregate ATTACHED ACORD 101 City of Fart Collins PO Box 580 Fort Collins, CO 80522 Suc°,No.exs:_(S00) 935-2442 �u ,No�{33d) 659-8912 A ORt�$�ahia.highwayservice@natl.com INStJRER(SJ AFFORDING COVERAGE HAIC A �HsuReR a: National Interstate Insu�ance Company �2620 SHOULD ANY OF THE ABOVE DESCRIBED POEICIES BE CANCELLEO BEFORE TH� EXPlRATION DATE THEREpF, NOTICE WILL BE DELIVERED IN ACCORDATlCE WITH THE POLICY PROVISION9. AUTHORILED REPRESENTATIVE �� ACORD 25 (201fi103) Q 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACQRD �� A�RO AGENCY merican Highways Ins. Agency POLICY NUMBER EE PAGE 1 caRa�a EE PAGE 7 AGENCY CUSTOMER ID: BUSCINC-0') I.00 #: ADDITIONAL REMARKS SCHEDULE � NAMEOINSURED Busco, Inc. dba Arrow Stage Lines 4220 South 52nd St. "Omaha, NE 68117 1 N�ic cooe � �SEE P � f EFFBCTIVE DATE: ADDITIONAI. REMAftKS THIS ADDITIONAL f2EMARKS FORM IS A SCHEbULE 70 ACORD FpRM, FORM NUMSER: ACORD 25 FORM TITLE: Ceriiticate of Liability Insurance Description of OperationslLocationsNehicles: City of Fort Collins, its officers, agents and employees are additional insured on the auto liability and general liability policies pursuant to the terms and conditions of the policy. � The company will mail the ce�tificate holder written notice of cancellation. If possible, the notice will be mailed at least 30 days, � except for cancellation of non-payment of premium, which wilt be mailed according to the policy provisions, prior to the effective date of the cancellation. Any provision that is in conflict with a statute or rule is hereby amended to conform to that statute or rule. ACORD 101 (2008101) C�) 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD NCVAXM Page 1 of 1 DATE (MN�OD�'YYYY► A�RO� CERTIFICATE OF LIABILITY INSURANCE „a�zo2a THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHiS UPON THE CERTIFICAYE HOLDER. THiS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGAT]VELY AMEND, EX7END OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTtFICATE OF INSURAMCE DOES NOT CONSTITUTE A CONTRACT BETWEEN TkE #SSUING INSURER(S), AUTHORI2ED REPRESENTATIVE OR PRODUCEfl, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITlONAI. INSURED, the palicy(les) must have ADDI'TIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIV€D, subject io the terms and condltlons oi the poltcy, certain policies may require an endorsemenl. A statement on ihis certi(icate does not confer ri hts to the certiticate holder in Ileu ot such endorsement s). PRQpUC�R NAME: fMA Denver Team INEA, Inc. - Colorado Division PHONE �bx t 705 17th Street, Suite 100 � • 303-534-4567 NC Na : Denver CO 80202 Ao�AAEss: DenAccountTechs imaco .com INSURER S AFFORbIN6 COVERAGE NAIC 0 iNsuaerta: Hartford F�re Insurance Com an 19682 INSUAEO SHAMCON iNsuaeR e: Hartford Accident and Indemnity Com an 22357 Shames Constfuction Company, Ltd. iNsuc��ac _ Hartford Casualty Insurance Comp� 29424 5826 8risa Street, Suite E - Livermore CA 9455� INSUAER D: INSURER E : INSURER F : COVERA(3ES CERTIFICATE NUMBER:1061931039 REVISION NUMBER: 7HIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED 8ELOW HAVE BEEN ISSUEO TO THE INSURED NAMED ABOVE FOR THE POLICY PER10D INDICATED. NOiWiTHSTANDING ANY REQUIREMEN7. TERM OR CONDITION OF ANY GRNTFiACT pR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE AAAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLiClES OESCRIBED HEREfN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITI�NS OF SUCH POLIClES. LIMITS SHOWN MAY HAVE BEEN REDUCEO BY PAI� CLAIivlS. INSR TypE pf INSUAANCE ADOL'.§UBfi � pOUCY EFF POUCV EJ(P UTATS L7R IN IWVD POLlCYNl1MBER MhWD�'YYY AIM1Db1YY A X COMMERCIALGENERALLIABILITY 34 UEAAC9582 1I1/2Q24 1!4l2025 EACHOCCURRENCE I 52,000.400 � CLhRv1S•MADE X OCCUR PqEMISE��o�un� en�to --• 5300.000 X PO Qed 55.600 � tAED EXP jMy onta porsqn) 5 1U,000 PERSONAL & ADV INJURY $ 2.000.040 GEM'LAGaREGATE LIMI7APP�lES PEf7. I GENERAL AGGREGA7E 54,OOQ.000 POLICY X JECT LOC f � PFODUCTS - COMP/OP AGG S4,OOQ,OQO I OTHER. i I T^ S B AUFOMOBILELtABIUTY 34 UEA AC95B1 111J2024 1l1l2025 CUMBINEO SINGLE LIMI7 S 1,000.000 Ea ac6deni -�-�--.._. 1 X AMV AUTO BODII�Y IN,IURY (Per per5pn) E OWNEO SCHEOLlLED BODIi.Y iN.IURY �Per accidenq E AUTOS ONLY AUTOS X HIHED � X NONOWNED PfiOPEFi7YDAMAGE S AU fU5 ONLY AUTOS ONLY {Pe. acciden� I b C X UMBRELI..4LIA6 X� p��R 34 RHAAC8810 1/1/2424 111/2025 ! EqCHOCCURRENCE 510,OQO,QQO EJtC�SS UA8 ��MS�MaOE AGGREGATE S 10,OOQ,U00 � bED X 4 RETENTION 5 8 � WORKERSCUMPENSATION ER f OTH� AND EMPLOYERS' LIABILITY 34 WEA 685S46 1J1l2024 111l2025 X STATUTE i ER YIN fWYPROPRIETOA%PARTNERrEXECUTIVE a � L_ EACH ACCIOENi S 1,OOD,ODO OFF{CER�Mp�SBEREXCLUDED? N!A (Mandalory !n NF� E L. DISEASE - EA EMPLOYFE 51,000.000 If yos, descr�be under OESCRIPTION OF OPERAT�ONS babw E L. DISEASE - POLICY LIMIT S 1.00D,000 VJC . If Yes I Cha�rman ! � PresldenUCEO ! � UESCRIVTION OF OPERATIONS r LOCATIO►iS 1 VEHICLE3 (ACORD 101, Addltionel Rmsarka Schedule, mey be atteched 11 more apeca la requked) Property Coverage Policy #UM00�72532MA24A Effective Dates: 01lOi/24-01101t25 Insurer. XL 5pecialty lnsurance Company $250,000 �eased 8� Rented Equipment L+mit; $5,400 Deductible $777,500 Personal Property Limit $5 000 Deduchbfe 5PC FormlRC See Attached... CERTIFlCATE HOLDER CANCELLATION SHOULO ANY OF THE ABOYE DESCRIBED POUCIfS BE CANCELLED BEFORE THE EXPIRA7tON OA7E THEREOF, NOTICE WIIL BE pELiYERED IN Clty Of FOn COIiIf1S ACCORDANCE WRH THE POLECY PROVISIONS. Attn. Contractor's License / Business License 281 N. College Ave. auTr4oaizeoRePaEs�ranvE Fort Collins CO 80524 � �1�, v:� 41988-2015 ACORp CORPORATION. All rights reserved. ACORD 25 (2016l03} The ACORD name and logo are registered marks of ACOfiD 8870: 2 ' p AGENCY CUSTOMER ID: SHAMC4N LOC A: ACORD� ��" A6ENCY IMA, 1nc. - Colorado Division POLICY NUMBER CARflI�H ADDITIONAL REMARKS SCHEDULE NAIC CODE Page i of � NAMEbINSURED Shames ConsUuction Company, Ltd 5826 Brisa Street, Suite E Livermore CA 94550 EFFECTIVE DATE: THIS ADDITlONAL REMARKS FORM IS A SCHEDULE T4 ACORp FORM, FQRM NUMBER: 25 FORM TITLE: GERTIFICATE OF �IABIUTY INSURANCE Builders Risk Coverage Policy #UM00072532MA24A Effecdve Dafes: 01lOi/24-01107125 lnsurer: XL Specialty Insurance Company $30,OOO,DO� Any Qne Location (Masonry Non-CombusGble) Limtt $30,000,004 Per Disaster Limit $1,000,000 Transit Limit; $1,0OO,OdO Temporary Location Limit, $5,000,000 Frame Limit 3,5,OOQ Deductible $i0,000,000 Flood Sub-�imit; Sr25,000 Minimum Deduchble (Zone: C and Unshaded X) $5,000,000 Earthquake CR Sub-Limit 5%-$100,0�0 Minimum Deductible; 510.000,600 AN Oiher States Sub-Limit; $25,000 Oeductible Limited Pollution Liability Coverage. Policy #PCA08-5023838-0124 Effective Dates: 01/01/24-61l01/25 Insurer: Berkley Assurance Company $1,000,004 Per Occurrence; $1 000,000 Aggregate Hired Auto Physical Damage Coverage: Policy #34 UEA AC9581 ENective Dates: 01101l24-61l01125 Insurer B: See Above $100 Comprehensive Deductible $1,000 C�liision Deductible Auto Physica4 Damage Coverage Policy #34 UEA AC958t Effective Dates� 6il�1l24-01101l25 fnsurer B: See Above $1,000 Comprehensive Deductible $1,000 Collision Deductible ACORD 101 (2006l01} 0 2008 ACORD CORPORATION. Ail rights reserved. The ACORD name and logo are registered marks ot ACORD 8870: 3 ' of DATE (M W DOlYYYY) A� R�� CERTIFICATE OF LIABILITY INSURANCE 1/14/2024 TH1S CERTIFICATE IS ISSUED AS A MATTEA OF INFORMATION ONLY AND CONFERS PIO RIGHTS UPON THE CERTIFiCATE HOLDER. THIS CERTIFlCATE DOES NOT AFFIRMATIVELY OR NEGATiVELY AMEND, EXTEND pR ALYER THE COVEFiAGE AFFpRDED BY 7HE POLICIES BELOW. THIS CER7lFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACi BETWEEN THfi ISSUING INSURER(S�, AUTHORIZED REPRESBNTATIVE OA PRQDUCER, AND THE CERT1FiCATE HOLOER. IMPORTANT: It the certlflcate holder is an ADbITiONAL INSUREO, !he poilcy(ies) must have AppItIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subJect to !he terms end condltlons oi the poficy, certafn policles may require an endorsement. A statement on thls certillcate does not confer rf hts to the certificate hotder in Neu of such endorsement(s . ?RObUCER MAME: �Ibby SUfI Pa3mer & Cay, LLC pHQNE a 3050 Peachtree Rd NW • 404-633-5800 ac No : 404-991-6060 Suate 475 E•MAIL _ADDA�S3: libby sun�Aalm_erandcay.com ana�ra r.a �n�n� i a: Martford Underwriters Insurance Comqa� INSURED ASCESTR•02 INSURER B : Ascendant Strategy Management Group, LLC dba Clearpoint Strategy INSURERC: 75 Arlington St., FL 5 IHSt3ti6RD: Boston MA 02116-3936 IH9URER E: INSURER F : COVERAGiES CERTIFICATE NUMBER:734955528 REVISION NUMBER: NAIC If 30104 42374 THIS IS TO CERTIFY TMAT THE POLICIES OF INSURANCE LI57ED BELOW HAVE BEEN lSSUED TQ THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANOING ANY REQUIREMENT, TERM OR CONDiTION OF ANY CONTRACT OR OTtiER DOCUMENT WITH RESPEGT;O WHICFf THIS CERTIFICATE MAY BE ISSUEO OR MAY PER7AIN. T!-IE INSURANCE AFFOFDED BY THE POLtGIES DESCRIBED WEREIN IS SUBJEGT TO ALL THE TERMS, EXCLUSIpNS AND CONDITIONS �F SUCH POIICIES. LIMITS SHOWN MAY HAVE BEEN FEDUCED BY PAID CLAIMS. ��7p TYPEOF INSURANCE AN p�Isjy ep j POtICY NUMBER � M►�+UUDD+YYYF^ M�MrD' DNYYA UMITS I _ r_..—. �_T._ �.__.��_.__.__w�_.__ � A X E COIdRtERCIAL dENERAL �IABIUTY ` 20 SBA AP9VDS 1114/2Q24 1t14l2025 ��qCH 0(;CLIRREMCE S 1.000,000 � �A Aii�TB �E}uTEb j i CLAIMS•MADE x QCCUR � PREMISES�Ea ocarr,r�nce�_. S�.�OD.00� ` _ �T. _ ___ _ `_ _ I l MHD FXP (My one erson) � 10,000 ( I PERSOMAL & ADV INJURY a 1.000.000 GEN'L ApdREGATE UMIT APPLlES PER I GENERAL AGGREGATE 32.000,000 %t POLICY PRO II � — JEC7 �� PRODUC7S COMPlOP AGG S 2.000,000 OTHER E a A AUTOMOBILEUABItITY 20 S8A APBV�S f 1l14/2024 7l14/2025 ��`'�B�NEO SINGLE LIMIT g j,40D.000 (E@ acpd9nl) _ ANY AUTO � BQDILY INJURY (Per persan) $ OWNEO � f �HEDULED BODILYlNJURY(Peraoc�danl) S AUTOS ONLY �} AUTOS x HIAED � x NONOWNED PROPfiRTYDliMAGE $ AU7US ONLY ,_� AUTOSONLY (Por acciden ._ � E s — A X j�MBRELtA UA$ ''j X � p�GUR I� 20 SBA AP9VDS i 1/14/2024 1/14/2025 EnCH oCCURRENCE S 2.D00.000 EXCESS L1AB � CWMS�MADE I � AGGFEGATEF 52.00O.00D OE� � X � AETEN710N5 I S WOANERBCOAIPENSATION SR 07H f AtJD EMpLOYER8' LIABILITY I I STATUTE ER � YrN ANYPRCPAiETOA�PARTNERIEXECUTIVE f�"'�j N r A E.L EACH ACC�DENT ��S OFFiCER�MEMBE R EXCLUDED7 (Mendetory In NH) ��--} I E L DtSEASE • EA EMPIOVEEE S II yos. doscribo undur DESGRkP710N OF OPERAilONS bebw I E L. bISEASE � PdL�CY LIMl7 i S B Tech Serv�tes Proteswon�l Li�b- � ' H23TG31849•02 3l15l2023 3/151202A OccutrencelAepregete �2,000.000 B GWer L�ah,lity ( H23TG31949-02 3l15l2023 3t15/2024 �uu<<ence/Aggregate �$2,0�0.0�0 �l � DESCRIPTION 4F OPERATIONS � LOCAT10N8 � VEHICtE3 (ACORD 101, Additlonal Rema�ics Sch�dule, mey be allached fl more apece Is requPed) }� SHOULO ANY OF 7H� ABOVE bESCRiBLD PpUC1ES BE CANCEILEp BEFORE THE EXPIRATION DATE TFiEREOF, NOTICE WILL BE DELIVERED IN ACCaRDANCE WITH THE POLICY PROViSiONS. Ciry of Fort Coil�ns 215 N Mason St. Znd Floor Fort Coliins CO 80522 ACORD 25 {2016/03) AUTHdRiZEO REPRESEHTATIVE ��c�„��(.i,,,,,.,-� � m 1988-2015 ACORD CORPORATEON. All righta reserved. The ACORD name a�d iogo are reglstered marks of ACORD 2296 2 ' �f QATf (61M+OD/YYYY) ACORD� CERTIFICATE OF LIABILITY INSURANCE `� i�is�2a2a THIS CERTIFICATE IS ISSUEO AS A MATTER OF INFORMA710N ONLY Al�iD CONFEAS NO RIGliTS UPON THE CERTiFlCATE HOiDER. 7H1S CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGA7IVELY AIMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY 7FiE POLICIES BELOW. THIS CERTIFtCATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT SETWEEN THE ISSUING INSURER(Sj, AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. iMPORTANT: If the certiticate holder is an ADDITiONAL INSURED, the policy(fes) must have ADDITIONAL INSUflED provisions or be endorsed. if SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certaln pollcies may requfre an endorsement. A statement on thks certificate does not confer r{ hts to the cerlificate holder In Ifeu of such endorsement s). PRODUCER NAMEA Christina Babcock Nolmes Murphy & Associates �Ot�E . 612-322-6071 ac ho : 2727 Grand Prairie Parkway E-MAIL Waukee IA 50263 aoo»ess: cbabcockft�hoimesmurohv com INSUREO Gorman Roofing Sernces, LLC 2229 E. lin'tversity pr. Phoenix, AZ 85034 wsuRe►ta: The Continentallnsurance Com ar BLUTtiRpG ��URERB: �O�tl�2flt21 CaSU81�COrt1paF1Y u+suReRc: Transportation Insu�ance Company iNsuAeR�: CNA Insurancs NAIC C 35289 _ 2aaas 20494 F: COVERAGES CERTIFICATE NUMBER:955808875 REVISION NUMBER: THiS IS TO CEF7IFY THAT TFiE POLICIES OF INSURANCE LISiED 6ElOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLiCY PERIOD INOICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION �F ANY CON7RAC7 OR OTHER DOCUMENT WITH RESPECT TO WHfCH TFi1S CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, TFf� INSURANCE AFFORDED BY THE pOLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS ANq CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN HEDUCED BY PAfD CLAIMS. INSR �ypE OF INSURANCE AbOLj�UeR POUCY EFF� j�POLICY EXP I LIMTS LTR {yyy POIJCYfiUMBER MFNODIYYYY F MAWDfYYYY A X COMMERC4AL GHNERAL LIABILITY ! 7034711565 11/9/2023 1119/2p24 � FpCH OCCURRENGE S 1 000,000 � ' �AMA M CLAIFAS•MADE X OCCUR i { PREM�SES�Eaoewrreneo: 5500000 X I Contr Liab r.er � MED EXP (My one per�n) E 15 000 x Policy FormlxCU I PEASONAI & ADV INJURY $ 1 000,000 G£N'L AGGREGATE LIMIi APPLIES PER GENERAL AGGREGA-E b Z.OQ0.000 POLICY %� j�C7 %� LOC � LPFiODUCTS COMPIOP AGG $ 2 000,000 OTHEA r 5 B AUTOMOBILE LIA91L1TY 7034711551 11(9/2023 � 1719/2024 C�MBINEO SlrtGt6 LIMIT g � OQ0,000 {Es acotlentl X ANYAUTO BOOI�Y 4iJJUFY (PBrparsan) b I OWNED SCHEpUl£0 BpDILY INJUAY (Por accidgni) § �AUTOS ONLY AU705 HtRED NONOWNEO PROPERTYDAMAGE $ AUTOS ONLY i AUTOS ONLY �_�per accidonl� 5 B X' uMSR��v+uae X p��R I 70347t1534 itl912023 ti/91202a EqCHOCCURRENCE � 510,600.000 EXCE3S UAB C�qIMS-MADE I AGGREGATE S 10.Q00,000 � DE� ' X RETENTION 5 � � S � WORKERSCOMPEMSATION 70347115b8 11I912023 1119l2024 �x � gTATU7E ERH AND EMPLOYERS' LIABILITY �ANYPROPRtET6RiPAFTNEWEXECUTIVfl Ya N! A ! E L. EACH ACCIDENT S 1,OOQ,Q00 OfFICER!MEMBEREXGI.UbED? �{Mandalory In HH) � E L DISEASE - EA EMPLOYEF 5 1.OQ0,600 � If yas, dascribe undor t I QESCRIPTION OF OPERATIONS bebw I E.L.OfSEASE • POUCY LIMIT b 1,OQO,Q00 A LeaseNRented Eqwp � 7034711565 11/9/2023 11/3/2024 Limn 3200,p00 D PoquOon Uabdiry CS870364q1783 11l9l2023 11l9/2024 �au�rence Ume 52.600,000 � Aggregate LimR a2.aoo.00a DE3CRIPTION OF OPEflATSONS I LOCATION$ t VE1iIGLES (ACORD 101, Adtlltiona! RemarNe Sct�edute, mpy be etlached il mora 8pece la requUetl) Proof af Insurance CERTIFiCATE HOLDER CANCELLATI ON SHQULD ANY OF THH ABOVE DESCRIBED POLICIES BE CANCELLED 6EFORE 7HE EXPIRA710N DATE THfREOF, NOTICE WILL BE OELIYERED IN ACCORDANCE YYITH THE POLICY PROVISIONS. City of Fort Collins 281 N College Ave. �or# Collins CO 80526 AUi RIZED REPRESENTATIVE �Y ' � 1988-2015 ACORD CORPORATlON ACORQ 25 {2016/�3) The ACORD name and logo are registered merks of ACORO iHIS CERTIFICATE SUPERSEDES PREVtOUSLY ISSUEO CERTI�ICATE Ali rights reserved. 5975: 2 ' of ACORD� DATEjMMlDp/YYYYj �, CERTIFICATE OF LIABILITY INSURANCE �r�zrzo2a THIS CERTIFiCATE I$ ISSUED AS A MA7TER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDEii. THIS CERTIFICA7E Dp�S NOT AFFtRMATIVELY OR NEGATIVELY AMENQ, EX7£ND OR ALiER TNE COVEFiAGE AFFORDED BY TNE POLICIE5 BELOW. THiS CEATIFICA7E OF INSURANCE DOES NOT CONSTITUTE A CON7RACT BETWEEN THE ISSLIING INSURER(S), AUTHORIZED REPRESENiATIVE OR PROOUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the caRificale holder is an ADDITIONAL INSURED, the policy(ies} must have ADDITIONAL INSURED provisions or be endoraed. If SUBROGATION IS WAIVEp, subJect to ihe terms end conditiona of the policy, cer4ain poElciea may requfre an endorsement. A ststement o� thls cenificate does not confer ri hta to the certiticate holder in Ifeu of euch endorsement(s}. PRODUCER NAME: K8fQ11 S8I8S Arthur J. Gallagher F2isk Management Services, LI.0 PFiONE g�6 395 8547 '1N No1; 816-472-5517 4622 Pennsylvania Avenue, 5uite 920 ��--�---� Kansas City N10 64112 aUOA��ss: Karen Salas�ajg.com INSURER Sf AFF6RDINp COVERAQE NAIC N _.iHs�RERn; Emp�ers Mutual Casual' Com an 21415 INSURED V'ANSCOI-02 INSURER B: PIt1f18C0) ASSUf811GQ CO�TI�jI 41190 Winston Cole, LLC --- — -- --- dba Pella Windows & Daors, LLC �NSURER C: __ � _ 4200 Carson Street INSURER p� Denver CO 80239 INSURER E: INSURER F : COVERAGES CERTIFICATE NUMBER:1687828863 REVISION NUMBER: THIS IS TO CERTlFY THAT THE POLICIES OF INSURANCE I.ISTED BELOW HAVE SEElV ISSUED 70 THE INSURED NAMED A90VE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OF COIJDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WFiICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDEO BY TFiE POLICIES DESCRIBED HEREIN IS SUBJECF TO ALL THE TERMS, EXCLUSIONS AND COFJDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR AA�DL $�(1�fS - � � � � �� -� �� POUCY EFF POIICY�E%P � LTR TYPEOFINSURANCE POLICYNUMSER MM/DD/YYYY MMlODlvYYY LIMITS A X COMMERCIALCSENERALL1ABlllTY Y Y 6p54622 1/1J2024 1+112025 EACHpCCUARENCE 51,000,000 6AT,�l�E TbRER7E6"- CLA1M5-MADE x� OCCUR PREMISES IEa oCCunenCg S 500,000 MED EXP (An one person) 3 10,000 PERSONAL & ADV INJUFY $1,000,400 Y GEN'L AGGREGATE LIMiT APPLIES PER: GENERaI nGGREGaTE 52,000,400 POLICY %� ; jE � j_ X 1 LpC PRODUCTS • COMPlOP AGG S 2_000,000 OTHER: g A AU70MOBILELIABItitY V Y 6M54622 1/V2024 1�7l2025 MBINED IN LELIMIT g�,fl00,000 E eccidgnl ��_ X ANY AUTO BODILY INJURY (Per person) $ OWNED SCHEDULED BODILY INJURY (Per accldenly $ AUTOS ONLY AUTOS X HIRED X NQN-OWNED PROPERTY DAMAGE $ ��i � AUTOS ONLY AUTOS ONLY Per acdtlent $ A X UMBREILALIAB X OCCUR Y Y 6J54622 1/1I2024 1�11Z025 EACHOCCURRENCE $S,OOO,040 EXCESS LIAB C�AIMS-MADE AGGREGATE $ 5,000,000 DEO I`� RETENTIONS � µ �� S `� g WORKERSCOMPENSATION Y 4239504 1I1/2024 111J2025 X PER OTH• AND EMPLOYERS' ItABILITY �� N STATUTE ER ANYPROPRiETOR/PARTNER/EXECUTIVE � NJA E.L.EACHACCtDENT 51,000.000 OFFICE R/MEMBER EXCLUDED4 � (Mendetory in NH) E.i.. DISEASE - EA EMP�OYEE $ 1,000,000 II yes, descrlbe untler DESCRIPTION OF OPERATIONS bebw E.L. DISEASE POLICY LIMIT $ 1,000,000 DESCRtPTtON OF OPERATIONS/ LOCATIONS! VEHICLES (ACOHO 701. Addltipnal Remarke Schsdula, mey be etteched if mare epeu is requfred� Genera! Liability - Blanket Additional Insured - Owners, Lessees or Conlractors - Automatic Status When Required in Consiruction Contracts or Agreement Including Completed Operalions - Primary and Noncontributory per form CG 7174 - Blanket Additional Insured - as Required by Contract per form CG 7579 - Blanket Waiver of Subrogation per form CG 7578 - Blanket Primary and Non-contributory Additional Insured per form CG 7578 CERTIFICATE H City of Fori Collins Communiiy Development and Neighborhood Sery 281 N. College A Fort Collins CO 8Q526-d400 �y� ��7 l� 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD ACORD 25 (2016/03) CANCELLATION $kOULD ANY OF THE ABOVE DESCRIBED POLICIES 8E CANCELLED BEFORE THE EXPIRATIUN DATE THEREOF, NOTICE WILL BE DELiVERED IM ACCORDANCE WITk THE POLiCY PRpY1SIOt�FS. AUTHORIZED REPRESENTATIVE � bA7E (MNiDDlYYYY) A�ORO� CERTIFICATE OF LIABILITY INSURANCE ��grz02A TNIS CERTIFIGATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICAtf HOLDER. Tiif5 CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGAI�VELY AMEND, EXTEND pR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE bF INSURANCE DOES NOT CONSTtTUTE A CONTRACT BETWEEN THE ISSUING INSURER(S}, AUTWORIZED REPRESEtJTAiIVE OR PRODUCER, AHO THE CERTIFICATE HQLDER. IMPOATAtVT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL lN5URE0 provisions or be endorsed. if Sl18ROGATiON IS WAIVED, subject to the terms and condfNons of the policy, Certain policies may require an endorsement. A statement on this certiflcate doe5 not confer ri hts to the certlffcate holder In lieu of such endorsement(s . PAODUCER NaME � Samuel Feldmart CRS Insurance Brokerage PHONE . 303-996-7800 � ac r,o : 303-757-7719 9780 S Meridian Blvd Suite 400 E�Ma� Englewood CO 80t 12 no�aess: sfeldm_ an cLiicrsdenver com _ iNSURED Colorado Civil Infrastructure, Inc. 2049 W Hamilton PI. Englewood CO 80110 INSURERA: �If1f12C0�l�SSUf3f1CB coav•z �Nsus�Re: Selective Ins. Co of Amerfca INSURE R C : INSUREfi D : lNSURER E : NAIC 0 41190 12572 COVERAGES CEA7IFICATE NUMBER:2009667939 REVISION NUMBER: THIS IS TO CERTIFY THAT iHE POtICIE5 OF INSURANCE LISTED BELOW HAVE BEEN ISSl1ED TO THE INSURED NAMED ABOVE FOR THE POLICY PERI00 INOICATED. NOTWlTHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR 07tiER D�CUMENT WITH RESPECi t0 WHICH THIS CERTIFICATE MAY BE ISSUED OFi MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLIGES DESCRI$EI� HEREIN IS SUBJFCT TO ALL THE TERMS. EXCLUSIONS AND CpNDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADOL SUBR POLICY EFF POLICY EXP LTR TYPEOFINSURAHCE IN O WV01 POUCYNUM9ER MAI�'DDlYYYY MMlDDIYYYY LiMTS 8 X COMMERCIALGENEqALL1A81UTY y S2505300 3/1l2023 31112Q24 EqCHOCCURRENCE 51.000,000 CLAIMS•MADE x pCCUR DAMA 10 R N J _ PRCMISES (£a ocairrence}_ S 5d0,00Q � MED ExP tAny oro pe�son) S 15,000 I PERSOVAL & hOV INJURY 5 1.00O,D00 G£N'L AGGREGATE LIMIT APPLIES PER. GENERAL AGGREGATE 52,000,000 pOUCY � �E � LOC PRp6UCTS - COMP;OP AGG b 2.004,006 QTHER S B AUTOMOBILE UABIUTY 52505300 3/1l2923 3r�t2o24 COMBINED SINGLE L� S 1.000,000 �Ea a:ndenl) x ANY AUTO BpDILY INJURV (Per person} y OWNE� SCHEDULED j BODILY IN,IURV (Pe� ax�dentl $ � AUTOS ONLY AUTOS x� HiREO X NONOWNED PROPERTYDAMAGE S AUTOS O�ILY AUi05ONLY �tPer acciden�( j J a B X i uMBRELUILIAB � p�CUR 525053d0 � 3l1l2023 3/1/2024 � EqCHoc;CURflENCE 55,000.000 � Ef(CESS tIA6 ��,q�MS-MAOE ff AGOREGAT£ S 5,OOD,OOU � DEO I^ j RETENTIONS { �f b q WORKERSCOA7PENSATION 4189142 � 2J1l2024 211J2O25 X SFATUTf E�Rµ AND EMPLOYERS' LIABILiTY YtN ANYPROPFIETOR�PAR7NEPoEXECUTIVE � N/ A E.L EACH ACGIDENi E 1.000,000 OFFICER'MEA46E R EXCLUOED? {Mandatory In NM) ! � E L DISF.ASE EA FMPL.OYEE S 1,000,000 � tl yo-s, describe wider I pESCRIPTION OF OPEflATIONS bebw E I E.L DISEASE - POLICY LIMIT j 1,000,000 B Leased end Rented Equipment 525053Q0 3/1/2023 3/1/2024 LimA 100,004 Dedu cubl e 1, 000 DESCRIPTION OF OVERATIONS+ LOCATIONS YEHICLES [ACORo t01, AddlUooel Rernsrke 9chedule, may be attaclied if more epece ta reQuked) Ramos Diaz-Owner City ot Fort CoAms is kncluded as additional msured on the Genera Liability with respect to ongoing operations of the named fnsured for the certificate holder as required by written contract ICATE HOI.DER Ciry of Fort Collins Development Review Center 281 N Coliege Ave Fort Coilins CO 80524 ACORD 25 {2016/03) SHOULD ANY OF THE ABOVE DESCR18E0 PQLICIES BE CANCELLED B�FOFiE THE EXPIRATION DATE THEREOf, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH 7HE POUCY PROVISIONS. AUTH�AIZEO RfVRESENTATiYE � �i'f�--�.�# � � / . ' `r' f�''^,-. ,r� � 1988-2015 ACORD CORPORATION. All rigfits reserved. The ACORD name and logo are �egistered marks of ACORD 5976: 2 ' of �. PO Box 2368 8loomfngton IL 61702-2368 rs2a aT, 2a 002893 0093 CITY OF FORT COLLINS, PURCHASING DIVISION PO BUX 580 ' s FORT COLLINS CO 80522-0580 � �lii��i��iliill��li��iii�u��i��ni�lllil��i��luillll�l�li � � � 0 0 � DATE OF N�TICE: JAN 15 2024 CODE: NOTE: PLEASE NOTIFY STATE FARM AT THE ADDRESS LISTED AT THE TOP, LEFT CORNER OF THIS PAGE REGARDING ANY CHANGE OF ADDRESS INFORMATiON. AD�iTIONAL INSURED'S NOTICE OF COVERAGE State Farm Mutual Automobile Insurance Campany 1902-FBBBA NAMED INSURED: POLICY NO; 197 7465-A01-44 COVERAGE: STANTON CONSTRUCTABILITY YR/MAKE/MODEL: 2016 FORD PICKUP BI AND PD LIABILITY SERVICES LLC VIN/CAMPER: 1FTEW1EG1GKF83287 $� MIL PQ BOX 581 127 AGENT NAME: MATSON 1NS AND FIN SRVCS INC $500 DED. CQMP. SALT LAKE CTY UT 841 58-1 1 27 AGE�lT PHONE: SSoo DED. COLL. ENDORSEMENT NO: 60P8$J� 4447 pOLICY EFFECTIVE JAN 01 2024 UNTIL TERMINATED v � � c N ro 90 0 � c 8 N POLICY MESSAGES: This policy shown above supersedes policy# 1245810-44Z. The policy includes a loss payable clause protecting the additional insured's interest in the described car to the extent ot ihe insurance provided and subject to all policy provisions. The additional insured will be given 10 days notice if the policy is terminated. UMiI such noiice is provided, it shall be presumed that the required renewal premiums have been paid. The additionai insured must notity us wiihin 1 o days ot any change of interest or ownership coming to their attention. Failure to do so will render this policy null and void. F.q1 o �R � CERTIFICATE 4F LlABILITY INSURANCE DOli15l20�onvnr� THIS CERTIFICATE IS iSSUED AS A MATTER OF INFORiNATION 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 pF INSURANCE DOES NOT CONSTITt1TE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICA7E 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 ta the terms and conditions of the policy, certain policies may require an endorsement. A statement on this cerlificate does not conier rights to the certificate holder in lieu of sucfi endorsement(s). PRODUCER CONraCT Marsh U.S.Operalions NAME: MARSH USA. LLC. vHONE 866�966 4664 FAX I7 2 948 0770 540 W. Madison Sueet (ac. r+o. EKtJ: {AlC; NoJ: Chicago, u_ 606fit nonR�ess: Ch�cago.CerlReqaest@marsh.com Alm: Veolia.CerlRequeslC�marsh.com � Fax: 212-948-5053 — � iNsuAeo Veolia ES Technical Solulions, LLC 53 Slale SUeet, 741h fbor Boslon, MA 02t09 INSURER(S) AFFOROING C( VESTS Boslon �NsurteR a: Everesl Nalwnal Insurance Com � +ksuReR e: Everesl Premier Insurance Comp� tNSURER C : NJA cNsuneR o: 8erkle Assurance Company cNsuReR e: National Fue & Marine Insurance Co NAIC r 1012C 16045 NfA 39461 20079 COVERAGES CERTIFICATE NUMBER: CHI-00749&336 58 REVISION NUBABER: 6 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 REOUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTMER DOCUMENT WITH RESPECi T� 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. L4MITS SHOWN MAY HAVE BEEN REDUCED 8Y PAID CLAIMS. INSR ADDLjSUBR POUCV EFF POLICY EXP LIbtI7S LTR nPE OF INSURANCE 1 ppLICY NUMBER MMIDD/YYYY MMlDD/YYYY a X COMMERCIALGENERALLIABILfiY RM5GL000G8�24i 41101/2024 01101I2025 EACHOCCURRFNCE $ ��•� D'AMAGE TO RENTED CLAIMS-MAOE X OCCUR PREMISES;Ea occurrenc� $ �� MEO EXP (Any one per5onl $ �� PERSONAL 6 ADV INJURY $ �'�'� G[N'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGAEGATE 5 ��•� FOUCY P�� LOC PRODUCTS - COMPlOP AGG 5 ��•� X JECT — OTHER: $ A AUTOMOBILELIABILITY RM5CA00066-241 (AOS} OliO7I2O24 01/0112025 COM8INED SINGLE LIMIT $ �� Ea aceidenf� A X aNv nuro RMSCA00065-241 (MA� O110112024 �110112025 BODILY INJURY (Per perwN 5 OWNED SCHEDULEO �ODILY INJURY (Per accidenl) $ AUTOS ONLY AUTOS HIRED NON-OWNED �'�OPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY _(Per accidant) S UMBRELLA LIAB OCCl1R EACH OCCURRENC@ $ EXCESS LIAB CLAIMS-MAD£ AGGF7EGA7E $ UED RFTENTION $ � B WORKERSCOMPENSATION RMSWC00092•241 (AdS) Ol Ol 2024 Oi10112625 x PER QTH• pND EMPLOYERS' LIABII.ITY STATUTE ER B V!N RM5WC00094-241(FL,ME,N)j 01/011202A O110112025 �.ppp,ppp ANYPROPFtIETOWPARTNERlEXECUTIVE N �! A E.L. EACH ACCIDENT $ g OFFICER/M£MBEREXCLUDE07 ❑ RM5WC00095-241 (WI, MA) 01/0112024 O1N?112025 {Mandatory in NH) E.L. DISEASE • EA EMPLOYEE $ �•�� If yes, descnbo uM1er DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ �•�� E CPL - SIR: Si,000,U00 42 CPL-326094-p2 O1l0112024 0710112025 OccurencelAggregale 1,000,000 D E&Q - SIR: 510.000.000 PCAB-5024616-0124 O11011202d 01l0112025 Per ClairtrlAggrPtjale 1,0OO.OpO DESCRIPTION OF OPERATIONS / LOCATIONS! VEHICLES (ACORD 101, Additional Ramarka Schedule, may be atlached it more space is required) City ot Fon Couins is included as atldilional insured {�xcept as respecls all coverage aflorded by wakers' compensalan and professional liability) where required by written contracl bul a�ly fa liability arising out of the operations ol lhe nam�d insured. A waivcv of subrogalion is granled as requireci by wrilten contraG bul only fa liabihty arising c�ut of Ihe operalions of ihe named insured. CERTIFICATE HOLDER City of Fort Colfins P.O. Box 580 Fart Collins. CO 80522 GANCELLATlON SHOULD ANY OF 7HE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 7HE EXPIRATION DA7E THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POUCY PROVISIONS. AUTHORlZED REPRESEN7ATIVE '�'Jiasidlc 2L �>� .L�l�C O 1988-2016 AGORD CORPORATION. All rights reserved. ACORD 25 (2016/03} The ACORD name and logo are registered marks of ACORD xacerar�,r 5 I A 1 t fAhiM� �. PO 8ox 23&8 BJoomington !L 61702-2368 i58A AT1 20 003U83 0093 CITY OF FORT COLLINS, PURCHASING DIVISION PO BOX 580 � FORT COLLINS CO 80522-0580 '�"I"��'�l��II�II��II"'�""!"I'lll�ll��'�lIII"II'��I��"� 0 0 8 � :� 0 0 A DATE OF NOTICE: JAN 12 2Q24 CODE: NOTE: PLEASE NOTIFY STATE FARM AT THE ADDRESS LISTED AT THE 70P, LEFT CORNER OF THIS PAGE REGARDING ANY CHANGE OF ADDRESS INFORMATION. ADDIiIONAL INSURED'S N�TICE OF COVERAGE State Farm Mutual Automobile Insurance Company 1902-F888A NAMED INSURED: POLICY NO; 197 7a65-AOti-4a COVERAGE: STANTON CONSTRUCTABILITY YR/MAKElMODEL: 2016 FORD PiCKUP BI AND PD L1ABlLI7Y SERVICES LLC VIN/CAMPER: 1FTEW1EG1GKF83287 $� M�' $500 DED. COMP. Pp BpX 58� t27 AGENT NAME: MATSON IN5 AND FIN SRVCS INC $500 DED. COLL. SALF LAKE CTY UT 84158-1127 AGEN7 PIii3NE: (801)981-4447 ENDORSEMENT NO: fi028BJ PQLICY EFFECTIVE JAN 01 2024 UNTfI. TERMINAI'ED a � � � N � � 0 m 0 8 N POLICY MESSAGES: ih�s policy shown above supersedes policy# 1245810-44Z. The policy includes a loss payable clause protecting the additional insured's interest �n ihe described car to ihe extent of the insurance provided and subject to all policy provisions. The additional insured will be given 10 days notice if the policy is terminated. Until such notice is provided, it shall be presumed that the required renewal premiums have been paid. 7he additionai insured must notify us with�n 10 days ot any change of interest or ownersh�p coming to iheir attention. Failure to do so will render this policy null and void. rRr pATE (MM1DDlYVri) ACORO� CERTIFICATE OF LIABILITY INSURANCE �� ` o,i2s�2o2a TF{�S CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGH75 UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE ROES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY T1iE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, ANU THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIdNAI INSURED, the policy(ies} must have ADDITIONAL INSURED provislons or be endorsed. li SUBROGATION IS WAIVED, subJect to the terms and condittons of the policy, certain policies may requlre an endorsement. A statement on this �ertiticate does not confer rights to the certificate holder in lieu of such endorsement�s). PRODUCER NTA T Mpody-Valley InsuranceAgenCy, InC. NAME: Moody-Valiey insurance Agency. Inc PHpkN Ex ;(970j 246-8300 �C No :(970) 242-1894 760 Horizon Drive. 5uite 302 E-MAIL �rtrequestgj@moodyins.com ADDRESS: tNSURER�S) AFFORUING COVERAGE NASC q Grand Junction CO 815Q6 iHsuRERA: American Select Insurance Co 19992 INSURED INSURER B: Pin�8C01 ASSUfdnC@ 41190 Advanced Lme Systems Inc iNSurteR C: �� Hawley Insurance Company 37974 Go Jamie Poe INSURER D: 121 S W 6th AVB INSLRER E: Broomfeld C� 8�02� INSURER F: COVERAGES CERTIFICA7E NUMBER: 24/25 Master REVISION NUMBER: 7HIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERI00 INDICATED NONNTHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT W1TH RESPECT TO WNICH TNIS CERTIFICATE MAY BE ISSUED OR MAY PER7AIN THE INSURANCE AFFQRDED BY iHE POLICIES DESCRIBED HEREIN IS SUBJECT TOALL THE TERMS, EXCLUSIONS AND COND TiONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCEO BY PAID CLAIMS. ��7p �YPE OF INSURANCE INSD WVD POLICY NUMH£R MMIODY/YYYV MMlODIYYYY LfMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE S �•000,000 CtAIMS-MADE �(k:Ci.R PREMiSES Eaoccurrence S 500,000 X WY Stop Gap-EL S,OOQ MED EXP (Arry one parson) S A Y TRA015342Y 01130l2024 01/30/2025 pERSONALBADVINJURV S 1•000,000 GEN'LAGGREGATELiMITAPPUESPER GENERALAGGREGATE S 2A00,000 X pOLICY � ECT a LOC PROWCTS-COMPfOPAGG g 2.000,060 OTHER WY Stop Gap-EL 5 1,000,000 AUTOMOBILE LIABIUTY COMBINEO SINGLE LIMIT 5 1,000,000 Ea accideM X ANYAUTO BOPILY INJURY (P9r per5ql) 5 A OWNED SCHEDULED TRA015342Y 01/3O/ZOZ4 O1/3O/ZOZS BODILV INJURY (Per acciAent) E AUTOS ONLY AUTOS HIRED v NON-0WNED PROPERTY pAMAGE S X AUTOS ONLY /� AUTOS ONLY Per accident S UMBREILA LIAB X OCCUR EACH OCCURRENCE � S,OOO,000 A X EXCESS LIAB CUIMS-MADE TRA015342Y Ol/30l202A 01/30/2025 AGGREGATE S 5,000,060 DEO X RETENTiON E� 5 WORKERS COMPENSATION X ST TUTE E�RH AND EMPLOYERS' LIABILITY y! H ANY PROPR�ETOR/PARTNEWEXECUTIVE E L EACHACCIDENT b 1,000,000 g OFFICERIAAEMBER ExCLUDED7 � N!A 4720673 02/01/2024 02/01/2025 (Mandatory In NHJ E L DISEASE • EA EMPLOYEE S 1,000,060 If yes, describe under 1,000,000 DESCRIP710N Of OPERA710NS below E L DISEASE - POLICY LIMIT S Blanket LimiVACV $896,374 Contraclors Equipment A TRA075342Y o1/3012024 01/30/2025 Deductible $500 DESCRIPTION OF OPERATIONS / LOCATIONS ! VEHICLES (ACORD 101, Additlonal Remarka Schedule, may be attached ff more apace la requfred) City of Fort Collins Engineering Dept 281 North College Ave PO Box 580 FaA Collins ACORD 25 (2016l03) SHOULD ANY OF TH� ABOVE OESCRIBED POLICIES BE CANCELLED BEFORE THE ExPIRATJON DATE THEREOF, MOTICE WILL 8E DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE CO 80522 �� v(.�,C,I.Q� l�}wI +(Jc,� -�ITjtQ j/Sf�f/% - � - �Q.. - - (J O 1968-2015 ACORD CORPORATION. All rights reserved. The ACORD name and Iogo are registered marks of ACORD AGENCY CUSTOMER ID: � — - - � � LOC #: '`��R�� ADDITIQNAL REMARKS SCHEDULE Page or AGENCY NAMEOINSURED Moody-Va11ey Insurance Agency, Inc. Advanced Line Systems, Inc POLICY NUMBER CARRIER NAIC GOOE EFFECTIVE OATE: ADUI I IUNAL KEMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 2$ FORM TITLE: Certificate of Liabildy Insurance: Notes Owners Jamie Poe Cody Sleinfeld, Colte Russell are excluded irom Workers Compensation coverage CONTRACTUAL LIABILITYAPPLIES PER POLICY TERMS AND CONDITIONS General Liability General Liability FormsAltached Include: Blanket Additional Insured status applies only to Ihe extent provided in iorm CG 20 10 Q4 13 and form CG 20 37 04 13 and form CG 7137 12 17 when required by writlen contracl Blanket Waiver of Subrogat�on applies only to the exlenl provided in form CG 7137 12 17 when required by writlen wnlracl Primary and Non-Contributory stat�s only ro the extent provided in form CG 7137 12 17 when required by wr�tlen contract Designated Pro�ect General Aggregate applies only to the extent provided in form CG 25 03 OS 09 when requ red by wntten conlrect Designated Location(s) General Aggregate applies only to the extent provided in form CG 25 04 A OS 09 Coniractors Pollution Liabibty: Coniractors Pollution Liabi ity - Insurer C: Ml. Hawley Insurance Company, NAIC 37974 Policy fVo EGLOOi0934, EHective 08l0912623 to 08l0912Q24. $2,000,000 Each Pollut�on lncident; $2.000,000 Aggregate L�mit 52,500 Per Claim peducSible Contractors Pollution L�ab�l�ty Forms Attached Include: Blanket Addilional Insured stai�s applies only to ihe exlenl provided in form CPL 701 03 23 when required by wniten conlract BEanket Waiver of Subrogation appiies only to the extent provided in form CPL 1Q1 Q3 23 when requ red by wntten contract Primary and Mon-Contributory status only to the extenl provided in form CPL 101 03 23 when required by written contract Auto Liability' Auto Liabilily FormsAttached Include� Blanket Additional Insured statvs applies only to the extent provided in (orm CA 70 77 10 13 when requ red by written contract Blanket Waiver of Subrogation applies only to the extent prov ded m form CA 04 44 10 13 when required by written contracl Primary 8 Ncn-Contribulory applies onty lo the extent prov.ded m form CA OA 49 11 16 when requ red by wntten contract Excess Liability Excess Liabili�y policy is on a follow form basis for the fo'lowmg underlying insurance coverages General Liab lity, Automobde Uabdity, and Empfoyers Liabilily Additional msured stalus wdl follow when reqwred by wntten contract nc�uding Pnmary and Non-Contributory status when requfred by written Worker's Compensation 359-8 From Attached Includes Blanket 1Nawer ot Subrogabon Status applies when reqwred by wntten conSract. IMPORTANT The pohcy forms referenced will be sent va emad only To oblain copies, please send your request with the email address to certrequestg�@moodyins com 1Q1 (2006/01) O 2008 ACORb CORPORATION. All rights reserved. Tha ACORD name and logo are registered marks of ACORO A a � CERTIFICATE OF LIABILITY INSURANCE �A'Q;;;6;2a24"r� THIS CERTIFICATE IS IS9UED A9 A MATTER OF INFORMATION ONLY AND CONFERS NO RIOHTS UPON THE CERTIfICATE HOLDER. THIS CERTIFICATE DOE9 NOT AFFIRMATlVELY OR NEOATIVELV AMEND, DCTEND OR ALTER TNE COYERqpE AFFORDED BY THE POLJCIES BELOMf. THIS CERTIFlCATE OF INSURANCE DOES NOT CONSTITUTE A COHTRACT BETWEEN THE ISSUINO INSURER(S), AUTHORI2Ep REpRESENTATIVE OR PRODUCER, AND THE CERTIFICA7E HOLDER. IMPORTANT: It the certiflcata holder is an ADDITIONAL INSURED, the pdicy(ies) musl have ADDITIONAL INSURED provislons or be endorsed. If SUBROOATION IS WAIVED, subJect to Me terms and condilions oi the policy, certain policiaz may require an erwforsement. A sfatemerrt on this certifleate does not cqrt}er ri to the certflicate hdder in Ileu o! tuch endorsemerrt(s). PRODUCER Nnr"aT� �T CUENT CONTACT CENTER FEDERATED MUTUAL�NSURANCE COMPANY HOME OFFICE: P O. BOX 328 AlC�No, r�at�:888-333-4949 lai, xol; 507-446-4664 OWATONNA, MN 55000 E•MAIL INSURED CONDUCT ALL SLEGTRIC 7352 GREENRIDGE RO STE A-4 W N�SOR, CO 80550-8062 aooRcss:CL1ENTCONTACTCENTER FEDINS.COM INSURERS AfFORDIHO COVERAGE NAIC q iNs�Aen a:FEDERATEO MU7UAL INSURANCE COMPANY 13935 17`2-$6S4 IN3URER B: IHSURFR C: INSURER 0. INSURER E: INSURER F: COVERAOES CERTIRCATE NUMBER: 46 REVISION NUMBER: 0 THIS tS TO CERTiFY THAT 7HE POLIClES OF IMSURANCE L'STED BELOW HAVE BEEN ISSVED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWiTHSTAND NG ANY REQUIREMENT TfRM OR CONOITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPEC7 TO WHICH THIS CERTIFICATE MAY BE SSUED OR MA7 AERTAIN. THE INSURANCE AFFORDEO BY 'HE POLICIES OESCRIBED HEREN -S SUBJECT TO ALL THE TERMS. EXCWSI6MS AND CONDtTIONS OF SUCH POLIC�ES. UMITS SHONRJ MAY NAVE BSEN REOl10E� BY PAID CL41MS. � TYPE Of IpSURANCE '�� POJCY �IUMBER P � EFF POUGY E%P LIMITS X COMMERCIlLL 6ENERAL UABtIITY EACH OCCURREMCE g1,000,000 CWMS•NAUE �pCCUR AMAGETO EMEOPREMIBEb E��Q MEO E%P (My one pMon) S�O�� A N N 6094153 02/'9/2024 02l19M025 pER50NAL 6 YDV INJURY �1,000 000 4ENL Al16RECATE UMIT APP�IES FER: X POLICY �E o- u LOG OTMEq: auroMos�Le uaewTv X ANYAVTO n A OWNEOAVTOSONLYI IQ��U EO N N NriEDAVTCSONLY ri^oa�o�mEo 1� �.fi1BHELLA.IAB A �xrbg.g�ipg DED RETEN7ICA WORKERS COMPENSATION ANO EMPLOYERS' LIA0ILITV PNY PROPRIETORJPARTNER/ fXECUTIVE /\ OFFlCERIMfMBERfMCWDEO? �M�ntl�bry In NH� �� yes, aaserloa u�av OESCRIPiION Of OPERATIOXS Mlow 6094�53 N � N j 6094155 N/A� N � 6094156 PROWCTJ 6 COMPIOP A06 COMBIpED SINOLE UMIT Ea �mhn HODtLY INJURY (Pa Pan 02/19/2024 02/l9/202$ gODILY INJURY IAn Ncci EACH OCCUF 02/19/2024 02/'9/202$ pcGPEOAre X PER STA7UTE � i. 02/19/2024 02/79/2025 E.L EacM acCloeNT E.L DI6EASE EA EMP�pYEE E.L DISEA�E POLICY UMIT $t,000,000 f5,000,060 ;1,0OO,OQO s1,000,000 DESCRIP710N OF OPERATIOMS 1 LOCATIOH31 �EMICLES �ACORD 101, Adeitiorol Rrm�rks SsMdule, m�y he �tl�rhed it maee spaca i� nquine� CERTIFICATE HOL,pER 172-565� CITY OF FORT COLLINS PARKING SERViCES 215 N MASON ST FL 1ST PO B�X 580 FORT COLLINS, CO 80522-0580 CANCELLATION �� SHOULD ANY OF 7HE /180VE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIYERED IN ACCORDANCE WITH THE POLICY PROVtSIQNS. AUTHORIZED REPRESENTATIVE • �./ T j•^�i O 1988-ZOfS ACORD CORPORATION. AII �iyHs reserved. ACCRU 25 (2018/03) The ACORD name and logo are registared marks of ACORD �� A� O DNIHEAT-01 CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDDlYYYY) � nsi2a�a 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 AL7ER 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 ADDI710NAL 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 rit�hts to the ce�tifitate holder in Ifeu of such endorsementtsl. PRODUCER PFS Insurance Group 4846 Thompson Parkway Sufte 200 Johnstown, CO 80534 INSURED b.N.l. HeatinglA.C./Refrigeration Inc. PO Box 565 14196 CO Itd 7 Mead, CO 80542 sas-saoo nsurance.com �r,suRsa a: Citizens Insurance Comnanv of America fi35-9401 3�534 COVERAGES CERTIFICATE NUMBER: R�YISI�N NUMB�R: THIS IS T� CERTIFY TFiAT THE POLICIES OF INSt1RANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMEd ABOVE FOR THE POLICY PERIOD INdICATED. NOIWITHSTANDING ANY REQUIREMENT. TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT VNTH RESPECT TO VNiICH THIS CERTIFICATE MAY BE ISSUEO OR MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES I.IMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TypE OF INSURANCE ADUL SUBR pp�CY Nl1MBER POLICY EFF POIJCY E7(P LIMITS A X COMMERCIAL GENERAL LU181LITY EACH OCCURRENCE a 1,000,000 CLAIMS�AADE X OCCUR 60539025 5I1l2023 5J�JQaQ4 DAMAGHTORENTED ��,��Q &E&1Ea�ue,7anr�l 5 _______ MED EXP M one rson E 5,�� PERSONAI 8 ADV INJURY S �,�OO,OOO GEN'L AGGREGATE LIMIT APPLIES PER GENERAI. AGGREGA7E y 2,QOO,OOO X POLICY �,j��7 [ 1 LOC PRODUCTS COMPlOP AGG 3 Z+OOO,OOO dTHER A AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 5 1,OOO,QOQ X ANY AU70 64539025 5/i i2�23 51�12024 BODILY INJURY Per rson E ONMEO SCHEDULED AUTOS ONLY AUTOS BODILY INJURY Per eccideM S X AUTOS ONLY X AU�OS ONLY ��a08��e�pAMAGE a 1 A X UMBRELLA LIAB X OCCUR FACH QCCURRENCE a 4,4��,400 excess une CLAIMS�AADE 64539025 511l2023 5I112024 pGGREGATE g 4,000,000 DED X RETENTiON S d B WORKERS COMPENSATION �( PER OTH- AND EMPLOYERS' LIABIUTY ANY PRQPRIETOR/PARTNERIEXECUTIVE Y f N B4H4T8312 ZIi JZO24 zI112O23 'I,OOO,OOO FFICER/ME Mg�� EXCLUDE6? �Y N I A E L. EACH ACCIpENT $ �iAandatory In N►f) E L. OISEASE - EA EMPLOYE S 5,��,�� It yes, describe under � 9,000,000 DESCRIPTION OF OPERATIONS bebw E L DISEASE - POUCY LIMIT DESCRIPTIOH OF OPERATIONS ! LOCATIONS / VEHICLES (ACORD 70i, Adeltlonat Remarks Schedute, may be etteched Ii more apace Is roqulmd) City of Fort Collins 261 N College Fort Collins, CO 80524 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCOROANCE WITH THE POLICY PROVISIONS. AUTHORIZE� REPRE8ENTATIVE ��;�� t�y,;� __ - ACORD 25 (2016I03) O 1988-2015 ACORD CORPQRATtON. All rights �eserved. The ACORD name and logo are registered marks of ACORD �� A� � DNIHEAT-01 CERTIFICATE OF LlABILITY INSURANCE DATE (MMlDD/YYYYj 7HIS CERTIFICATE IS ISSUED AS A MATTER pF INFORMATION ONLY AND CONFERS NO RIGH7S UPON THE CERTIFICATE HOLDFR. TIiIS 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 HOLOER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(les) 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 ce�tificate does not confer rights to the certificate holde� in lieu of such endorsement(sS. PRODUCER PFS Insurance Group 4848 Thompson I'arkway Suite 20U Johnstown, CO 80534 INSURED D.N.I. HeatinglA.C.IRefrigerdtion Inc. PO Box 565 14196CORd7 Mead, CO 80542 :,,,�: (970) 635-9400 . info@mypisinsurance.com INSURERjS� AFKORDING COV� a: United Fire 8� Casualty Co e:Citizens Insurance Gomp� c: 635-9401 534 COVERAG�S CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY TtiAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICAZED NOTVNTHSTANDING ANY RE�UIREMENT TERM OR CONDITIbN OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, iHE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOVMI MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR 7ypE OF INSURANCE ADDL St1BR ppuCY NUMBER POUCY EFF POUCY EXP LIMIT9 A �( COMMERGIAL GENERAL LIABILITY EACH OCCURRENCE g �eQOO,OOO CLAIMS-MADE u pCCUR 60539025 51112023 511l2024 �'�`�AGE TO RENTED �D�,��a .P.SEMISES_(E��+a� $ MED EXP M one rson S b,�� PERSONAL 8 AOV IHJURY g ��OOO�OOO GEN'L AGGREGATE LIMITAPPLIES PER_ GENERAL AGGREGATE f 2,00O,OOQ X POLICY � j��T � LOC PRODUCTS - COMPlOP AGG S 2,000,000 OTHER: A AUTOMOBILE LIABILITY ��B�IN�e� INGLE LIMI7 = i3OO4,000 X ANY AUTO 60539025 511/2023 511I2024 gpDILY INJURY Per erson E OWNEP SCNEDULED AUTOS ONLY AtJTOS BODiLY INJURY Per accident E X AUTOS ONLY X AUTO� ONLY _{Pe�a�e�mpAnMGE � f A X UMBRELu� LIAB X OCCUR Ep,CH OCCURRENCE S a,OOO,OOO � EXCE5SLIAB CLAIMS-MA�E 60539025 5/1/2023 511I2024 AGGREGATE S 4,��,�� DED X RETENTI�N $ � B WORKERS COMPENSATION X PER OTH- AND EMPLOYER$' LIAHILITY Y f N yyg4H478312 y��2024 2/112025 i��0�� ANY PROPRIETOR/PARTNER/EXECUTIVE � E.L EACH ACCIDENT 5 QFFlCERlMEMBEREXCLUDED7 � Y , N!A i�OOO�OOQ (Mandatory in NH) E.L DISEASE EA EMPLOYE S It yes, describe under 1,000,000 DESCRIPTION OF OPERATIONS bebw E.L. DISEA E• P LICY LIMIT DESCRIPTION OF OPERATIONS ! LOCATIONS ! YEHICLES (ACORO 101, Additfonsl Remarks Scheduls, may be attached it moro apece Is requfrad) City of Fort Collins 281 N College Ave. Fort Collins, CO 80524 SNOU40 ANY OF THE ABOVE DESCRIBED POLICIES BE GANCEILED BEFaRE THE EXPIRATION DATE THEREOF, NO�ICE WILL BE DELIVERED IN ACCOROANCE WITH THE POLICY PROYISIONS. AUTHORIZED REVRESENTATIVE �-��f� ��_ - ACORD 25 (2016103) �O 1968-2015 ACORb CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD �R�� CERTIFICATE OF LIABILITY INSURANCE DATE (MMIpDIVYYY} 112512024 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, EXTEMD OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 7HIS CERiIFICATE OF INSURANCE DOES NOT CONSTI7U7E A CONTRACT BETWEEN THE ISSUING INSURER(S�, AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE GERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL fNSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION JS WAIVED, subject to the temts a�d conditions oi the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in Ileu of such endorsementls). PRODUCER IMA, Inc - Pittsburgh 316 First Avenue 3rd Floor Kittanning PA 16201 INSURED Transit Solutions, LLC 525 W New Castle St, Swte 1 Zelienopls PA 16063 COVERAGES Julie Hays K��: 724-548-5178 Julie.HaysC�Dima TRAMSOL-01 CERTIFICATE NUMBER: 1419054487 AFFORDfNG COVERAGE REVISION NUMBER: NAIC # 15792 � THIS IS TO CERTIFY TFiAT TNE POUCIES OF INSURANCE LlSTED BELOW HAVE BEEN ISSUEO TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTVNTHSTANDING ANY REOUfREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUEO OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALt TFiE TERMS F�CCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR A I U � POUCY EFF POUCY EXP L7R TYPE OF ItJSURANCE j POLICY NUMBER MMIDD/YYYY MMlDOlYYY LIMITS e X COMMERCWLGENERALLIABILITY Y Y S 2562229 113012024 1l30I2025 EACHOCCVRRENCE S 1,OOQ,000 CLAIMS•MADE X OCCUR PREMlSES Ee oNccurrence S 1,000,000 ,— �• MED EXP (Any one person) S 15,000 PERSONAL 8 ADV iNJURY 5 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER GENERAL AGGREGA7E S 3,000,000 X POLICY jE a LOC PRODUCTS - COMPlOP AGG S 3,000,000 OTHER S e AUTOMOBILELIABILIrr Y S 2562229 113012024 1130/2025 COMBINEDSINGIELIMIT y�,000,000 Ea aaidenl ANY AUTO BODILY INJURY (Per person) 5 OWNEO X SCHE6ULE0 BpDILY INJURY (Par acadant) S AUTOS ONLY AUTOS x HIR�D X NON•OWNED PROPER7YDAMAGE s AUTOS ONLY AUTOS ONIY Per acadenl 5 B X UMBREL�a LIAB X p�CUR S 2562229 113012024 1130J2025 EACH OCCURRENCE S S 000 000 EXCESS LIAB CLAIMS-MADE AGGREGA7E 3 S 000 000 DED X RETENTIOMS S C WORKERSCOMPENSATION Y WVbC3687935 113012024 1l30l2025 X PER OTH- ANDEMPLOYERS'LIABILITY Y!N STATUTE ER ANYPROPRIETOR/PARTNERIEXECUTIVE N E L EACH ACCIDENT 5 1 000,000 OFFICERfMEMBEREXCLUDEO? N�A (MandNory In NH) £ L DISEASE - EA EMPLOYEE S 1 000,000 II yes. tlesuibe untler DESCRIPTIpN pF OPERATIONS �elow E L DISEASE - POLICY LIMIT S 1,000,000 A Errars & Omissions ESM0139867156 1130J2024 7130l2025 Each Occurrence $2,000,000 Aggragate $2,000,000 DESCRIPTION OF OPEHATIONS 1 LOCA710N51 VEHICLES iACORD f 07, Additional Remarks Schadule, may be attached if more space is required) CertifiCate Holder and all other pa�lies required by the contract are inciuded as Additional Insured on the General Liability and Automobile Liability Policies. if required by written contract or agreement, subject to the policy ierms and condilions. A Waiver of Subrogation is provided in favor of ihe Certificate Holder and all other parties required by the contract on ihe General Liability and Workers Compensation Policies, ii required by wririen contract or agreement, subject to the policy terms and conditions. lJmbrella Liabiliry policy is in excess of ihe General Liability and Automobile Liability Policies, subject to the policy tenns and conditions. City of Fort Collins 215 Norih Mason St. PO Box 580 Fort Collins C� 80524 ACORD 25 (2016103� SHOULO ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATlVE ��.��- O 1988-2015 ACORD CORPORATION. All righis reserved. The ACORD name and logo are registered marks of ACORD A�� CERTIFICATE OF LIABILITY INSURANCE DATE(MNVDDMlri) O 0111812024 THIS CERTIFICATE IS ISSU�D AS A MA77ER OF INfaRMATION ONLY AND CONFEAS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DpES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE dF INSURANCE DpES NO7 CdNSTITUTE A CONTRACT BETWEEN THE ISBUING 1NSURER{S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFkCATE HOi.DER. IMPORTANi: If the certlficate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIQNAL 1NSUREQ provistons or bs endorsed. If � SUBROGATION IS WAIVEO, subject to the terms and conditions o! the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certiHcate holder in Ileu of such endorsement(s). �� PRODUCER NOMN��ACT d a AOr1 Risk Insurance Services West, Inc. f393� 758-7688 �� (303) 758-9456 d D811veP CO OifiCe (NC. No. EKq NC. No. : .a 200 clayton Street, Suite 800 E-MAfL Q Denver CO 80206 USA aDDRESS: _ r;�;.`� � INSUHED POwUr p6C 2583 via de la valle Suite 321c Del Mar Ca� 92014 USA � INSURER(S) AFFORDING COV£RAGE NAIC # INSURERA: TF1e C011tlll@f1td� Insurance Company 35289 iNsuRERa: Colony insurance Company 39993 INSUREfi C: INSURER 0: INSURER E: INSUREH F REVISION NUMBER: THIS fS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD � INDICATED. NOTWITHSiANDING ANY REQUIREMENT, TERM OR CONpITION OF ANY CONTRACT OR OTHER OOCUMENT WITH RESPECT TO WHICH THIS *" CEFITIFICATE MAY BE ISSUEO OR MAY PERTRIN, THE �NSURANCE AFFORDED BY THE POIICIES DESCRI6ED HEREIN IS SUBJECT Tp ALL THE TERMS. EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. �IM�TS SHOWN MAY HAVE BEEN REDUCEd BY PAID CLAIMS. Limits shown are as r uested LTR TYPE OF �NSURANCE I�p yJyD POLtCY NUMBEfl MM/DD�YYYY MhVDD.'YYVY LIMI7S X COMMERCIALGENERALLIASILITY PA��S EACNOCCURRENCE S1,OOO,OOO CLAIMS•MADE a�;CI.R PREMISES Ea ottunenCe 41Q0 , 000 MED EXP (My one person) S 10 , 000 PERSOMAL 8 ADV INJURY $1, OQO , O00 � GEN'LAGGREGATELIMRAPPLI£SPER� GENEFALAGGREGATE S3,OOO,OOO � X POLICY ❑ PR� ❑ LO(; PROOUCTS•COMP/OPAGG S3,OQ0,000 � JEC7 OTHER oeducobie S SQ , 000 n AIIrOMOBItE 1IA81LffY COMBINED SINGLE LIMIT � E i n ANY AUTO BOOILY INJU RY � Per person � � Z OWNED SCHEDULE� BODILY INJURY (Per accidem) a> AUTOS HIREOAU�TOS NON•pWNED PROPERTYDAMAGE V ONLY AUTOS ONLY Per accident — .� � UMBRELLALIAB OCCUR EACH OCCURRENCE V EXCESS LIAB CLAIMS-MADE AGGREGATE DED RETENTION A WORKERS COMPENSA710N AND S 1 1 x PER STATUTE O7H� EMPLOYERS' 11A81LITY y � N A� � Other Stdt@5 � ANYAROPRIL-TORlPARTNER/[XECUTIVG E.L.EACHACCfDENT SZ,OOO,OOO A' OFFICEWMEMBERE%CLUDED? � N!A 703653zia7 Q1�Q1�Z024 01�01/2�Z5 (Me�dalory In NFq �p, E.L. DISEASE-EA EMPLOY�E S 1, OOO , O00 If yes, dosc�bo urWer OESCFlIPTION OF OPEAATIONS bolow E.L. DISEASE•POLICY LIMfT $1, 000, 000 --- e E8A - Professional Liability vaCES4281806 O1/20/2024 O1/O1/2Q25 Aggregate Limit 3,000,0 0 - primary Claims-Made Each Occurrence �im 51,000,000 � DESCRIPTION OF OPERATIONS / IOCATIONS I VEHICLES (ACORD 101, Addl[lonsl Remerks Scheduie, mey he etteched if more 9paCe Is required) � � � � CERTIFICATE HOLDER CANCELLATION � SHOULD ANY OF TH£ ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPINATION OATE THEREpF, NOTICE LViLL BE DELIVERED IN ACCORUANCE WITH THE POLICY PROVISIONS. �L Ci ty Of FOf't CO11 i n5 AUTMORIT60 REPRESENTATIYE � Development Review Center ' 281 N. College Ave. �� G�� ,��„ �� Fort Collins CO 80524 uSA �� m1988-2015 ACORD CORPORATION. All righis reserved. ACORD 25 (2816103) The ACORD name and logo are registered marks of ACORD AC�RO� � AGENCY CUSTOMER IQ: 570000087114 LOC At: ADDITI4NAL REMARKS SCHEDULE Page _ of AGENCY NAMEDINSURED Aon Risk Insurance Services west, inc. Powur PBC POLICY NUMBER see certificate Number: 570103648580 CARRIEA NAIC CODE See Certificate Number: 570103648580 EFFECTIVEDATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FQRM, FQRM NUMBER: ACORD 25 FORM TITLE: Certificate oi Liability Insurance INSURER(S) AFFORDING COVERAGE NAIC # INSURER 1NSURER INSURER 1NSUKER ADDITIONAL POLICIES If a policy beluw does not include limit information, r�fer to the corresponding policy on the ACURD certifcate form for policy limits. vo�icv ro�.rcv INSR ApDL SUBR POI.fCYNU1�IB�:R Llb1175 LTR T1'PEOFINSUNANCE ��Sp ��,yp EFFF.CTiVE EXNIRAYION nATB DATE (AIAIIDDl1'Y\'1'1 (Al!1VDD/YYYl') OTHER B contractors Pollution PACEs4281806 O1/20/2024 Ol/OZ/2025 Aggregate 53,0�0,000 Liability Limit EdCh 51,000,000 Occurrence ACORD 101 (2008101) �2008 ACORR CORPORATION. Afl rights reeerved. The ACORU name end iogo ere registered ma►ks oi ACORQ �c �� CERTIFICATE OF LIABILITY INSURANCE onre IMM�oommy THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGH7S UPON THE CERTIFICATE HOLDER. THIS CERTIFlCATE DOES NOT AFFIRMATIYELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONS7lTUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AIJTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: I! the certificate holder is an ADaITtONAL INSUREp, the pollcy(les� must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to lhe terms and conditiona ot the policy, certaln policiea may require an endorsement A statement on this certificate does noi confer ri ht8 to the certlflcate holde� in Ifeu of such endorsemen s. aaoouceR NqME CT Joe B ant Risk Strategt@S PNONE 214 323-4602 ac No : 214 503-889 12801 North Central Expy. Suite 1725 E•MAIL Dallas, TX 75243 RSCcertre uest risk-strate ies.com W SURED Fiuitt-Zollars, Inc. 5430 LBJ Freeway Suite 1500 Dailas TX 75240 COVERAGES CERiIFICATE NUMSER: 78275975 REViSIpN NUMBER: THIS IS TO CERTlFY THAT THE PO�ICIES OF INSURANCE LISTEQ BELOW HAVE BEEN ISSUED TO THE INSUREO NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY RE�UIREMENT, TERM OR CONOITION OF ANY CONTRACT OR OTHER DOCUMENT W1TH ftESPECT TO WHICH THIS CERTIFIGATE MAY BE ISSUEO OR MAY PERTAIN, TNE INSURANCE AFFORDE� BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. UMITS SH01NN MAY HAVE BEEN REDUCED BY PAIp CIAIMS. INSR 7ypE pF iNSURANCE A�� POUCY EFF POUCY EXP LTR POLtCYNUMBER MM D MM IJMITS COMMERCIALGENERALL}ABIUTY EACHOCCURRENCE 5 A�ET6�fFEN CLAIMS-MApE OCCUR PREMI E Ea octurrente E MED EXP (Any one person) S PERSONAL 6 ADV INJURY E GEMLAGGREGATELIMITAPPLIESPER: GENERALAGGREGATE E POLICY � j� a � LOC PRODUCTS - COMP�OP AGG S OTHER: E AUTOMQBILELIABIl1TY COMBItJEDSktJGLE LIMIT E Ee acueent ANY AUTO BODILY INJURY (Per person) S ONT7ED SCHEDUIED 80DILY INJVRY (Per actidenl) E AUTOS ONLY AUTOS H RED NON-OWNED PROPERTY OAMAGE a AUTOS OT7LY AU70S ONLY Per acadenl a Uh18RELIA UAB OCCUR EACM OCCURRENCE S FJ(CESS LIAB C�,qIMS-MADE AGGREGATE S DED RETENTION 5 E WORKERSCOMAENSATION PER OTH- ANDEMPLOYERS'LIABILITY TAT T ER ANYPqOPRIETOR/PARTNER/EXECUT VE Y! N OFPtCER�AEM6EREXCLUDED'/ � N�A E.L.EACHACCIDENT E (ManAatory Vn NH) E.L. pISEASE - EA EMP�OYEE S II yes. tlestnbe uMer DESCRIPTIOM OF OPERATIONS bebw E.L. DISEASE - POLICY LIMIT 3 A Pro(essional Liability � EBZ665006/0il2024 1/23/2024 1/23/2025 Per Claim $1,000,000 Pollution Liabiliry Annual Aggregate $1,000,000 DESCRIPTION OF OAERATIONS! LOCATIONS ! VEHICLES {ACORD 701, Additional Rsmarks ScMduls, may ba att�ched if moro sp�ce I� rcqulnd) The claims made protessional iiability caverage is ihe total aggregate limit for all claims presented within the annual policy period and is subjed to a dedud�ble. Thirty (30} day notice of canceflation in favor of the cert�ficate holder on alf policies. RE: Project No: R304965.01 — North College Pedesirian Gap Project CERTiFICATE HOLQER ceNr_Fi i nrin�u Ci of Fort Collins 28� North College Avenue Fort Collins CO 80522 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 7HE EXPIRATION DATE THEREOf, (10TICE WILL BE DELIVERED IN ACCORDANCE WI7H THE POLICY PROVISIQNS. AUTHORIZED REi'RESENTATIVE � G�� Joe Bryant ACORD 25 (2016103� OO 1888-2015 ACORD CORPORATION. Atl rights reserved. The ACORD name and logo a�e registared marks of ACORD ��-� .- I-4.: PL Mast=r (S1M/52M Cefau!tf I tiya tectuqa 1!/151'.024 8:29:5� AH .:Fi� Pa�c 1 c_ . �-1 ACORO� �� PEAKAUD-01 CERTIFICATE OF LIABILITY INSURANCE OATE �MM/DONYYY{ 1124l2024 THIS CERTIFICATE IS lSSUED AS A MATTER OF INFORMATiON ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NO7 AFFIRMATIVELY QR NEGATIVELY AMEND, EXTEND OR ALTER TH� COVERAGE AFFORDED BY 7HE POLICIES BELOW. THIS CERTIFICATE OF INSURANGE DOES NOT CONS71TU7E A CONTRACT BETWEEN THE ISSUING INSURER(S}, AUTHQRlZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE H�LDER. IMPORTANT: lf the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL tNSURED 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 oE such endorsemenk(s). PRODUCER CONTACT Ryan Condel' NAME: Carver and Associates Insurance Services, ��]C. PHONE FAJ( 7710 Ralston Road �ac, r+o, sx:�: {303) 996-5371 ��, No�:(303) 431-7629 Arvada, CO 80002 n oR�Ess: rconder@carverandassociates.com INSURED Peak Audio Visual, LLC dba CCS Presentation Systems 700 West Mississippi Ave, Unit A6 Denver, CO 80223 INSURER{S) AFfORDING COVERAGE iNsuaeRn:EMC Property � Casualty lns Co �r,suRER e : Pinnacol Assurance INSURER C : INSURER D : INSURER E : NAIC # _ 25186 _ 41190 COVERAGES CERTIFICATE NUMBER: REVISiON NUMSER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR TFiE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY RE�UIREMENT. 7ERM OR CONDITION OF ANY CONTRAC'C OR 07HER �OCUMEN7 WITH RESPECT TO VN-IICH TMIS CERTIFICATE MAY BE ISSUED OR MAY PER7AlN, THE iNSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT Tp ALL THE TERMS, EXCtUSIONS AND CONDiTIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSFiI TYPE OF INSURANCE aDOL�SUBR pOUCY NUMBER ��P�LICY EFF I POUCY EXP LIMITS A X COMMERCIAL GENERAl. LIRBILITY I EACH OCCURRENCE S �,OOO,OOO � CLAIMS•MADE X OCCUR �( �( �6X52629 2l18I2024 111l2U25 pREMI$ES�{EaEoNcwRence) S 500�000 MED EXP (My one persanJ $ ��,aQ� PERSONAL 8 ADV INJURY g �,OOO,OOO GEN'L AGGREGATE lIM1T APPLIES PER GENERAL AGGREGATE a 2,000,000 POUCY X P��T LOC PRODUCTS - COMPlO? AGG S 2rOOO,OOO OTHER y A AUTOMOBILE ilAB1LITY COMBINED SINGLE LIMIT 'I,OOO,UOO (Ea accidenl) 3 X ANYAUTO x X sX52629 2ii8I2�24 1I1/2fl2$ BODILYINJURY(Perpersnn� S OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INIURY ;Per acadenl) b AU70S ONLY AU OS ON�Y (Pe�aa dentj ��E 5 E A X UMBRELLA LIAB X OCCUR EACH OCCURRENCE g 3�000,000 EXCESS LlAB CLAIMS-AhADE X X 6X52629 2!'18/2024 1I112025 pGGREGATE a 3,��,�� DED X RETENTION 5 � O�UOO S B WORKERS COMPENSATIOt7 X PER OTH• AND EMPLOYERS' LIABILITY Y � N STATUTE ER ANY PROPRIEFORlPARTNERfEXECUTIVE 4ZZ9�O6 111/2024 11112025 i3OOO,OOO OFFICERfME MBER EXCLUDED? N N! A E l EACH ACCIptNT $ (Mandatory in NH) E L DISEASE - EA EMPLOYEE $ � r�� ir es, desu�ee �.naer 1,000,000 D�SCRIPTION OF OPERATIONS bafv.v E L OISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS! LOCATIQNS f VEHICLES (ACORD 701, Additlonal Remarks Schedule, may be attach6d if more space is required} All Projects of the insured - City of Fort Colllns is addltional insured if required by written contract. TION SHOULO ANY OF 7HE ABOVE DESCRIBED PpLICIES BE CANCEttED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WlLL BE �ELIVERED IN ACCORDANCE WITW THE POLICY PROVISIONS. City of Fort Collins Purchasing and Risk Management P. Q. Box 580 AUTHORIZED REPRESENTATIVE .�c'�'� -- - ACORD 25 (2016103) O 1988-2015 ACQRD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD ' �� ACORO' �� TMAHOLD-09 CERTIFICATE OF LIABILITY INSURANCE DATE {MMIDDIYYYY) THIS CERTIFICATE IS ISSUED AS A MAT7�R OF INFORMA710N ONLY AND CONFERS NO RIGHTS UPON THE CERTlFICATE HOLDER. THIS CERTIFICA7E bOES NOT AFFII2MATIV�LY OR N�GATIVELY AMENb, EXTEND QR ALTER THE COVERAGE AFFORDED BY THE POLICIES B�LOW. 7HIS CERTIFICATE OF INSURANCE DOES NOT CONSTfTUTE A CONTRAC7 BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESEN7ATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certiflcate holder Is an ADDITIQNAL INSURED, the poltcy(ies} must have ADDITIONAL INSURED provisions or be endorsed. If SU8f20GATION IS WAIVEo, subject to the terms and conditlons of the policy, certain pollcies may requ(re an endorsement. A statement on this certiftcate does not confer riahts ta the certiflcate holder in lieu of such endorsement(sl. PRODUCER ""o��ao.r �vv�v�va� Hub Inter�ational MEd-America 6100 S. Yale Avenue Suite 1900 Tulsa, OK T4136 INSURSD TMA Holdings LLC 1876 Utfca Square Third Floor Tulsa, OK 74114 m B) 551-7900 I ��u"c,wo�: ne.watsonCrDhubinternational.com COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMEQ ABOVE FOR THE POLlCY PERIOb INOICA7ED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION QF ANY CONTRACT OR �THER DOCUMENT 1MTH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFOftDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIAIIITS SHOWN AAAY HAVE BEEN REDUCED BY PAID CLAIMS. 1NSR TypE OF INSURANCE ADDL SUBR ppLICY NUMBER PaLICY EFF PQLICY EJfP LIMITS A X COMMERCIAL GENERAL LIABII�ITY EACH OCCURRENCE S ��OOO,OOfl CLAIMS-MApE U OCCUR BBO74B%H%S9 9l2212023 SIYYIYOZ4 DAMAGE TO RENTED 'I �OOO�OOO MED EXP (An�ate rson � �,�� PERSONAL & AOV INJURY � �OOQ,OOO GEN'L AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE Z,OOd,OOO POLICY � j��T � LOC PRODUCTS -COMP/OP AGG Z,OOd,OOd OTHER EPL a 'IO,OUd A AUTOMOBILE LIABIUTY C e accideMSINGLE LIMIT a 'I �OOO�OOO ANY AUTO B8074678759 9122l2023 912212024 BODILY INJURY Per erson S �WNED SCHEDULED T AUTOS ONLY AUTOS BORDILY INJURY Per aaitlenl S X AUTOS ONLY X AUTO� OM�Y P?ef Pa pOBTMflI AMAGE s S B X UMBRELLA LIAB OCCUR EACH OCCURRENCE S ��OOO�OOO ExCESS uAB CI.AlMS•MADE B6O74S7H762 912212D23 9I22J2O24 AGGREGATE E DED X RETENTIONS �Q�� Aggregate S rJ�Oa��O� C WORKERS COMPENSA710N x PER OTH- AND EMPLOYERS' LIABILITY C711555651 9J2212023 9i22iZOZ4 ��fl��0 ANY PROPRiETORlPARTNERIEXECU7IVE Y� E.L. EACH ACCIDEN7 QFFICERMIE M8E R EXCLUDED? N�A (klandatoryfnNH) E.L.DISEASE-EAEMPLOYE �,��,�a� �r ya5.de5�� -- �,000,000 DESCRIPTfON OF OPERATlONS bebw E.L. DISEASE - POLiCY LIMIT D Professional Liabili VG00004285AD 1?J2212023 1212ZI2024 AggregatelEach CEaim 4,OUO,U00 DESCRIPTtON OF OPERATIONS ! LOCATIONS! VEHICLES (ACORD 707, AQtlltionat RemaAcs Schetlule, may 6e attached if more spe ce Is requlretl} To the extent required by written agreement, signed 6y the insured, the Blanket Additional Insured endorsement applies to the Certificate Holder in reference to the General LiabiNty, Auto Liability and Excess Liability as their interests may appear. Ctry of CollEns 300 LaPorte Avenue Fort Colll►ts, CO 80521 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATfON DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE C�lv��..�� ACORD 25 (201fi103) O 1988-2015 ACORD CORPORATION. All rights reserved. 7he ACORD name and logo are registered marks of ACORD � ACOR�" �� AGENCY CUS70ME}2 ID: TMAHQLO-01 LOC #: 1 ADDITIONAL REMARKS SCHEDULE CRAMEY Page 1 of 1 AGENCY License # 400101891 NAME� INSURED ub International Mid-America TMA Holdings LLC 1876 Utica Square POLICYNUMBER Third Floor EE PAGE 1 7ulsa, OK 74114 CARRIER NAIC CODE EE PAGE 1 SEE P 1 EFFECTVE DATE: PAG The ACORD name and logo are registered marks of ACORD ACORD 101 (2008/09 ) O 2008 ACORD CORPORATION. All rights reserved. .4co DR � CERTIFICATE OF LIABILITY INSURANCE DA7E(MMlDD1YYYYj �� ,n,r2o2a THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CfRTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORQED BY THE P4tIGIES BELOW. 7HIS CER7IFICATE OF lNSURANCE DOES NQT CONSTlTUTE A CONTRACi 6ETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HQLDER. IMPORTAIVT: If the cerliticete holder Is an ADDITIONAL INSURED, the policy(fes) muat have ADDlTIQNAL INSURED pro�isions or be endorsed. If SUBfipGATION IS WAIVED, subject to the terma and conditions of the policy, certain policies may require an endorsement. A atatement on this certificate does not cortter ri hts to the certificate holder in lieu ot such endorsement(s). PRODUCER NTACT NAME;. LOfI ROSB _ _ _ _ Arthur J. Gallagher Risk Management Serv�ces, LLG pHor,e �- - ' " --� "- �" - " ( Fax — 12750 Merit Drive Suite 1000 ��n9 _�xu• _ __— ia�.±+�i:_ — Dallas TX 75251 AooR�Ess: Lori Rose�ajg com INSURED irench Right SPV LLC DBA Trench Right Colorado a500 E 60th Ave Commerce City, CO 80Q22 COVERAGES CERTIFICATE NUMBER:2Q12686905 wsuReaa: Nationwide Mutual Insurance Comr�any — -- _ ___— — - iNsuaeA e: AMCO Ensurance Com an nusuREac: Oe ositors Insurance Company msuAeR �: MarkeY American Insurance Company _ tNSURER E : REVISI�N NUMBER: Naic � 237$7 THIS IS TO CERTIFY THAi 7HE POLICIES OF INSURANCE USTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMEO ABOVE POR THE POLICY P'r R OD fNDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONOITIOIY OF ANY CONTRACT OR OTHER DOCUMEN' WiTH RESPECT 70 WH CH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY TFiE POLICIES DESCR BEO HEREIN iS SUBJECT TO AL_ THE T�RMS, EXCLUSIONS AND CONpITIONS OF SUCH POLICIES. LIMITS SHOWfV MAY HAVE BEEN fiEDVCEP 6Y PAIp CLAIMS INSR TYPE QF WSURANCE ADISL �UBR pOLICY NUMBER MM/DO/YYYY MM/bDlYYYY LIMITS LTR A X COMMERCIALGENERAL LIABiLITY Y ACP GLO 3110341248 4f112023 411l2024 EACH pCCUHRENCE S 1,000,000 CLA�MS-MADE i X I OCCUR PREMISE� eocturrenGe S 1,000,000 T MED ExP (An ona person) � 10,000 � PERSONAL 8 AOV INJURY 5 1,000,000 GEN'L AGGREGATE UMIT APPLiES PER GENERAI AGGAEGATE S Z,000.000 POLiCv I x� JEC�T X LOC PHO�UCTS � COM?!OP AGG 5 2.000,000 OTHER. S C AUTOMOBILE LIABILITY ACP BAPD 3110341248 411/2023 47112024 OM81NEb INGLE UMIT g �,000,000 Ea acciAenq X ANY AUTO BOOILY INJURY (Par pgrson) $ OWNED 5CHE�ULED BODLLY iNJURY (Per accident) S AUTOS ONLY AUTOS x HIRED x NON-OWNED PROPERTY DAMAGE g AUTOS ONLY AUTOS ONLY Per acddent S B X UMBRELLA LIAB X p��q ACP CAA 3110341248 4l112Q23 4l�I2024 EACH OCCURRENCE $ 5,000,000 EXCESS LIAS CLAIMS-MADE AGGREGATE S S,OOO,OQO DEO RETEN7�ON S g WORKERSCOMPENSATION ACP WCA 3110341248 4!1l2023 411l2024 X H- ANO EMPLOVERS' LIABILI7Y Y � N S7ATUTE ER ANYPROPHIFTOWPAHTM[FUEXECViIVG a E.L EACH ACCIDEN7 $ 1,000,000 OFFICEWMEMBEREXCLUDED? N/A (Mandalory in NH) E.L. DISEASE - EA EMPLOYEE 5 1.00Q.00Q II yeS, desCnbe under � DESCRIPTION Of OPEFiATIONS b910w E.L. DiSEASE - POLICY LIMI7 S 1.000,000 A Inland Marine ACP CIM 3110345248 4/112023 4l112024 leasedlRentetl Eqwp $100,000 � MKLM4EUE1011A7 4!1l2023 4l112024 InslaflationFloatar $100,000 8xcess Liability (SMz5M) Limit (Ea Occ1AC,G� $5,000.000 DESCRIPTION OF OPERATIONS / LOCATIONS J VENICLES (ACORO 101, Additional Remerks Schedule, mey be elteched if more epeee is requiredj City ot Fl Collins is included as Additiona! Insured as respects General Liability policy, pursuant to and subject to the poticy's lerms, definilions, conditions and exclusions. CERTIFICATE HOLDER City of Ft Coklins 281 N College Ave Fort Collins CO 80524 USA ACORD 25 (2Q16/03) CANCELLATIQN Sf10ULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DA7E THEREOF, NOTICE WILL BE DELIVERED IN ACCORUANCE WITH THE POLICY PROVISIQNS. AU7HORIZED REPRESENTATIVE Wl,�j, v �, �I'�"",' � 1988-2015 ACORb CORPORATION. All rights reserved. The ACORD name and logo are registered marks of AGORD