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HomeMy WebLinkAbout3 Tree Design House - Insurance Certificate DATE(MMIDDIYYYY) A�" CERTIFICATE OF PROPERTY INSURANCE 07/12/2023 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. PRODUCER CONTACT NAME: �ONE Ext (844) 472-0967 (FAX, lc No: (203) 654-3613 BIBERK E-MAIL salessupport@biberk.com P.O. Box 113247 PRODUCER Stamford, CT 06911 CUSTOMER D: INSURERS AFFORDING COVERAGE NAIC# INSURED INSURERA:Berkshire Hathaway Direct Insurance Compal INSURER B: 3 Tree Design House, LTD INSURERC: 3 Tree Design House 155 N College Ave Ste 114 INSURERD: Fort Collins, CO 80524-2455 INSURERE: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: LOCATION OF PREMISES I DESCRIPTION OF PROPERTY (Attach ACORD 101,Additional Remarks Schedule,if more space is required) See Attached THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION COVERED PROPERTY LIMITS LTR DATE(MMIDDIYYYY) DATE(MMIDDIYYYY) X PROPERTY BUILDING $See Attached CAUSES OF LOSS DEDUCTIBLES PERSONAL PROPERTY $ BASIC BUILDING N91313727990 08/10/2022 08/10/2023 BU61NESSINCOME $ BROAD CONTENTS EXTRA EXPENSE $ X SPECIAL RENTALVALUE $ EARTHQUAKE BLANKET BUILDING $ WIND BLANKET PERS PROP $ FLOOD BLANKET BLDG&PP $ $ INLAND MARINE TYPE OF POLICY $ CAUSES OF LOSS $ NAMED PERILS POLICY NUMBER $ CRIME TYPE OF POLICY $ BOILER&MACHINERY - - EQUIPMENT BREAKDOWNIs - -------- - -- $ _. S SPECIAL CONDITIONS I OTHER COVERAGES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN City of Fort Collins ACCORDANCE WITH THE POLICY PROVISIONS. 281 N. College Ave. Fort Collins, CO 80524 AUTHORIZED REPRESENTATIVE 01995-2015 ACORD CORPORATION. All rights reserved. ACORD 24(2016/03) The ACORD name and logo are registered marks of ACORD DATE ACCoR" CERTIFICATE OF LIABILITY INSURANCE (MMIDDIYYYY) 07/12/2023 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: BIBERK PHONE 844-472-0967 FAX 203-654-3613 P.O. Box 113247 E-MAIL o Ext: A/C No: Stamford, CT 06911 ADDRESS: customerservice@biBERK.com INSURERS AFFORDING COVERAGE NAIC# INSURER A:Berkshire Hathaway Direct Insurance Company 10391 INSURED INSURER B: 3 Tree Design House, LTD 3 Tree Design House INSURERC: 155 N College Ave Ste 114 INSURERD: Fort Collins, CO 80524-2455 INSURERE: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ILTR TYPE OF INSURANCE 1NM WVp SUER POLIPOLICY NUMBER MMIDDmFF MMIDDm P LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 2,000,000 CLAIMS-MADE �OCCUR DAMAGETORENTED PREMISES Ea occurrence $ 50,000 A N9BP727990 08/10/2022 08/10/2023 MED EXP(Any one person) $ 10,000 PERSONAL&ADV INJURY $ Included hGEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 4 OOQ 000 POLICY JECOT- LOC PRODUCTS-COMP/OP AGG $ 4,000,000 X OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED AUTOS ONL AUTOS BODILY INJURY(Per accident) $ Y HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per accident L $ UMBRELLA LIAB H OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED I I RETENTION$ $ WORKERS COMPENSATION I PER OTH- AND EMPLOYERS'LIABILITY Y I N STATUTE ER ANYPROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ OFFICER/MEMBEREXCLUDED? ❑ NIA (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ TOmIsP�ofessional Liabili Errors& —tY � PeI•�ccurrence/-sions): Claims-Made Aggregate DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Addhional Remarks Schedule,maybe attached it more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Fort Collins ACCORDANCE WITH THE POLICY PROVISIONS. 281 N. College Ave. Fort Collins, CO 80524 AUTHORIZED REPRESENTATIVE ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD 3 Tree Design House, LTD - N9BP72799O Supplement to Certificate of Property Insurance 07/12/2023 Berkshire Hathaway Direct Insurance Company Property List Address, City, State Zip Location: 3751 Summerwood Way Johnstown, CO 80534 Bldg #001: General Contractor - Performing Low Hazard Services- 7454102 Coverage Limit Building 0 Personal Property 0 Business Income and Extra Expense ALS up to 12 months Blanket Building n/a Blanket Personal Property n/a Blanket Building & Personal Property n/a Location: 155 N College Ave Ste 114 Fort Collins, CO 80524-2455 Bldg #001: General Contractor - Performing Low Hazard Services- 7454102 Coverage Limit Building 0 Personal Property 0 Business Income and Extra Expense ALS up to 12 months Blanket Building n/a Blanket Personal Property n/a Blanket Building & Personal Property n/a 0 0 0 0 0 0 m 0 M 0 0 0 a 0 a 0 a v n z 0 m Ply.