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HomeMy WebLinkAboutHahn Plumbing and Heating - Insurance Certificate 2025 '`��o® CERTIFICATE OF LIABILITY INSURANCE 7TM0Q/1M7'/DD0fYYY)Y 25 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 pollcy(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 certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER QQNIACI NAME: CLIENT CONTACT CENTER FEDERATED MUTUAL INSURANCE COMPANY ��— — HOME OFFICE:P.O.BOX 328 (q/c,No,Ext1:888 333-4949 (A/c,No):50T-446 4664 OWATONNA,MN 55060 E-MAIL ADDREss:CLIENTCONTACTCENTER@FEDINS.COM INSURERS AFFORDING COVERAGE NAIC# INSURER A:FEDERATED MUTUAL INSURANCE COMPANY 13935 INSURED INSURER B: HAHN PLUMBING AND HEATING 130 CHESTNUT ST INSURER C: FORT COLLINS,CO 80524-2403 INSURER o: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:54 REVISION NUMBER:3 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 ADDL SUBR POLICY EFF POLICY EXP LTR INSR'WVD POLICY NUMBER MM/DD/YYYY MMIDDIVYVV LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $1,000,000 CLAIMS-MADE LX J IOCCUR DAMAGE TO RENTED PREMISES $100,000 - (Ea occurrenre MED EXP(Any one person) EXCLUDED A N N 1921426 02/15/2025 02/15l2026 PERSONAL&ADV INJURY $1,000,000 OEN'L AGGREGATELIMI AAPPLIES PER: GENERAL AGGREGATE $2,000 000 I� X POLICY r:ECT ❑LOC OTHER: L—PE PRODUCTS&COMP/OP ACC $2,000,000 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT JANYAUTO (Es accident) $1,000,000 BODILY INJURY(Per Person) AOWNED AUTOS ONLY SAUTOS CHEDULED N N 1921426 02/15/2025 02/15/2026 BODILY INJURY(Per Accident) HIRED AUTOS ONLY NON-OWNED PROPERTY DAMAGE - AUTOS ONLY (Per Acciden') �UMBRELLA LIAB X OCCUR EACH OCCURRENCE $1,000,000AEXCESS LIAR CLAIMS-MADE N N 1921428 02/15/2025 02/15/2026 AGGREGATE $1,000,000 DED I RETENTION WORKERS COMPENSATION AND EMPLOYERS'LIABILITY YIN X PER STATUTE I OTHER ANY PROPRIETOR/PARTNER/EXECUTIVE A OFFICER/MEMBEREXCLUDED? N/A N 1921430 02/15/2025 02/15/2026 E.L EACH ACCIDENT $1,000,0()0 (Mandatory In NH) If yes,describe ender E.L DISEASE EA EMPLOYEE $1,000,000 DESCRIPTION OF OPERATIONS below E.L DISEASE POLICY LIMIT $1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be atta SEE ATTACHED PAGE ched If more space is required) CERTIFICATE HOLDER CANCELLATION CITY OF FORT COLLINS FORT COLLINS UTILITIES 3 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED PO BOX 580 BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN FORT COLLINS,CO 80522-0580 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE I I n © 1988-2015 ACORD CORPORATION.All rights reserved. ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: Ac"Ru LOC#: k.,., - ADDITIONAL REMARKS SCHEDULE Page 1 of 1 AGENCY NAMEDINSURED FEDERATED MUTUAL INSURANCE COMPANY HAHN PLUMBING AND HEATING 130 CHESTNUT ST POLICY NUMBER FORT COLLINS,CO 80524-2403 SEE CERTIFICATE#54.3 CARRIER NAIC CODE EFFECTIVE DATE'SEE CERTIFICATE#54.3 SEE CERTIFICATE#54.3 ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: CERTIFICATE OF LIABILITY INSURANCE POLICY COVERAGE AS OF 02/15/2025 ADDITIONAL NAMED INSUREDS INCLUDE HAHN 77 BUSINESS HOLDINGS GROUP LLC ACORD 101 (2008/01) O 2008 ACORD CORPORATION.All rights reserved. The ACORD name and logo are registered marks of ACORD '`� D® CERTIFICATE OF LIABILITY INSURANCE DATE(MM/02/17l025 2025 Y) 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(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 certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER NAME: CLIENT CONTACT CENTER FEDCONIACi ERATED MUTUAL INSURANCE COMPANY — -- HOME OFFICE:P.O.BOX 328 IAIC,No,EXt):888-333-4949 IA/c,No1:507-446 4664 OWATONNA,MN 55060 E-MAIL ADORESS:CLIENTCONTACTCENTERQFEDINS.COM INSURERS AFFORDING COVERAGE NAIC# INSURER A:FEDERATED MUTUAL INSURANCE COMPANY 13935 INSURED INSURER a: HAHN PLUMBING AND HEATING 130 CHESTNUT ST INSURER C: FORT COLLINS,CO 80524-2403 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:30 REVISION NUMBER:3 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 ADDL SUER POLICY EFF PODGY EXP LTR INSR WVD POLICY NUMBER MMIDD/YYYV MMIDDIYYYV LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $1,000,000 CLAIMS-MADE OCCUR DAMAGE TO RENTED PREMISES (Ea occurrence) $100,000 MED EXP(Any one person) EXCLUDED A Y N 1921426 02/151202S 02/15/2026 PERSONAL&ADVINJURY $1,000,000 GENL AGGREGAITE�LIMI AAPPLIES PER: GENERAL AGGREGATE $2,000 OOO OTHER ��}Y' X POLICY I EE�T ❑LOC PRODUCTS&COMP/OP ACC $2,000,000 : AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT JANYAUTO (Ea accident) $1,000,000 BODILY INJURY(Per Person) AOWNED AUTOS ONLY AUTOS SCHEDULED N N 1921426 02/15/2025 02/15/2026 BODILY INJURY(Per Accident) HIRED AUTOS ONLY NON-OWNED AUTOS PROPERTY DAMAGE ONLY IPer Accideno �UMBRELLA LIAB X OCCUR EACH OCCURRENCE $1,000,000 AEXCESS LIAR CLAIMS-MADE N N 1921428 02/15/2025 02/15/2026 AGGREGATE $1,000,000 DED I RETENTICN WORKERS COMPENSATION AND EMPLOYERS'LIABILITY YIN X I PER STATUTE OTHER ANY PROPRIETOR/PARTNER/EXECUTIVE A OFFICER/MEMBER EXCLUDED? N/A N 1921430 02/15/2025 02/15/2026 E.L EACH ACCIDENT $1.000,000 (Mandatory in NH) If yes,describe under E.L DISEASE£A EMPLOYEE $1,000,000 DESCRIPTION OF OPERATIONS below EL DISEASE POLICY LIMIT $1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101.Additional Remarks Schedule,may be attached it more space Is required) SEE ATTACHED PAGE CERTIFICATE HOLDER CANCELLATION CITY OF FORT COLLINS PO BOX 580 303 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED FORT COLLINS,CO 80522-0580 BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE --//ff'' nn kJu l © 1988-2015 ACORD CORPORATION.All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD '---IN AGENCY CUSTOMER ID: ADDITIONAL REMARKS SCHEDULE Page 1 of 1 AGENCY NAMEDINSURED FEDERATED MUTUAL INSURANCE COMPANY HAHN PLUMBING AND HEATING 130 CHESTNUT ST POLICY NUMBER FORT COLLINS,CO 80524-2403 SEE CERTIFICATE##30.3 CARRIER NAIC CODE EFFECTIVE DATE:SEE CERTIFICATE#30.3 SEE CERTIFICATE##30.3 ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: CERTIFICATE OF LIABILITY INSURANCE POLICY COVERAGE AS OF 02/15/2025 ADDITIONAL NAMED INSUREDS INCLUDE HAHN 77 BUSINESS HOLDINGS GROUP LLC RIGHT OF WAY CONTRACTOR'S LICENSE ACORD 101 (2008/01) O 2008 ACORD CORPORATION.All rights reserved. The ACORD name and logo are registered marks of ACORD At*�"® CERTIFICATE OF LIABILITY INSURANCE DATE(MM/02/17/2025 Y) 025 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(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 certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER NAME: CLIENT CONTACT CENTER FEDERATED MUTUAL INSURANCE COMPANY HOME OFFICE:P.O.BOX 328 IA/C,No,EXt):888-333-4949 (A/C,No):507-446-4664 OWATONNA,MN 55060 E-MAIL aoDRESS:CLIENTCONTACTCENTER(5)FEDINS.COM INSURERS AFFORDING COVERAGE NAIC 4 INSURER A:FEDERATED MUTUAL INSURANCE COMPANY 13935 INSURED INSURER B: HAHN PLUMBING AND HEATING - 130 CHESTNUT ST INSURER C: FORT COLLINS,CO 80524-2403 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:139 REVISION NUMBER:3 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 ADDL SUBR POLICY EFF POLICY EXP LTR INSR WVD POLICY NUMBER MMIDD/YYYV MM/DD/VYYY LIMITS X COMMERCIAL GENERAL UABILITY EACH OCCURRENCE $1,000,000 -71 CLAIMS-MADE OCCUR DAMAGE TO RENTED PREMISES (MAGI nce) $100,000 MED EXP(Any one person) EXCLUDED A N N 1921426 02/15/2025 02/15/2026 PERSONALS ADV INJURY $1,000,000 GENP LILY AI�TE_LIsM,IT APPLIES PER: GENERAL AGGREGATE $2 00O 000 X POLICY �FECOT ❑LpC PRODUCTS 6 COMP/OP ACC $2,000,000 OTHER: FFF"' AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT JANYAUTO (Ea accident) $1,000,000 BODILY INJURY(Per Person) AOWNED AUTOS ONLY SA, CS N N 1921426 02/15/2025 02/15/2026 BODILY INJURY IPer AccidenU HIRED AUTOS ONLY NON-GAMED PROPERTY DAMAGE AUTOS ONLY Per Acciden JUMBRELLA LIAR X OCCUR EACH OCCURRENCE $1,000,000 AEXCESS LIAB CLAIMS-MADE N N 1921428 02/15/2025 02/15/2026 AGGREGATE $1,000,000 DED I RETENTION WORKERS COMPENSATION AND EMPLOYERS'LIABILITY YIN X PER STATUTE OTHER ANY PROPRIETORIPARTNER/EXECUTIVE A OFFICER/MEMBER EXCLUDED? N/A N 1921430 02/15/2025 02/15l2026 E.L EACH ACCIDENT $1,000,000 (Mandatory In NH) If yes,describe under E.L DISEASE fA EMPLOYEE $1,000,000 DESCRIPTION OF OPERATIONS below E.L DISEASE POLICY LIMIT $1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101.Addillonal Remarks Schedule,may be attached if more space is required) SEE ATTACHED PAGE CERTIFICATE HOLDER CANCELLATION CITY OF FORT COLLINS UTILITIES DEPARTMENT 1393 PO BOX 580 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED FORT COLLINS,CO 80522-0580 BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE] © 1988-2015 ACORD CORPORATION.All rights reserved. ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD ----IN AGENCY CUSTOMER ID: Ac"Ro LOC#: ADDITIONAL REMARKS SCHEDULE Page 1 of 1 AGENCY NAMEDINSURED FEDERATED MUTUAL INSURANCE COMPANY HAHN PLUMBING AND HEATING 130 CHESTNUT ST POLICY NUMBER FORT COLLINS,CO 80524-2403 SEE CERTIFICATE#139.3 CARRIER NAIC CODE EFFECTIVE DATE:SEE CERTIFICATE#139.3 SEE CERTIFICATE#139.3 ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: CERTIFICATE OF LIABILITY INSURANCE POLICY COVERAGE AS OF 02/1.5/2025 ADDITIONAL NAMED INSUREDS INCLUDE HAHN 77 BUSINESS HOLDINGS GROUP LLC ACORD 101 (2008/01) O 2008 ACORD CORPORATION.All rights reserved. The ACORD name and logo are registered marks of ACORD ACOR" DATE(MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 02/17/2025 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(les) must have ADDITIONAL INSURED provislons 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; CLIENT CONTACT CENTER FEDERATED MUTUAL INSURANCE COMPANY All HOME OFFICE:P.O.BOX 328 (A/C,No,Ext):888-333-4949 (A/C,No):507-4464664 OWATONNA,MN 55060 E-MAIL ADDRESS:CLIENTCONTACTCENTER@FEDINS.COM INSURERS AFFORDING COVERAGE NAIC# INSURER A:FEDERATED MUTUAL INSURANCE COMPANY 13935 INSURED INSURER B: HAHN PLUMBING AND HEATING 130 CHESTNUT ST INSURER C: FORT COLLINS,CO 80524-2403 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:130 REVISION NUMBER:3 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 ADDL SUER POLICY EFF POLICY xP LTR IN SR WVD POLICY NUMBER MMIDD/YYYY MM/DD/YYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $1,000,000 CLAIMS-MADE (Ea o OCCUR D AEMAGE TOccurrtnre RENTED PREMISES $1001000 LL MED EXP(Anyone person) EXCLUDED A Y N 1921426 02/15/2025 02/15/2026 PERSONAL&PDV INJURY $1,000,000 GENT AGGREGATE LIMITAPPLIES PER: GENERAL AGGREGATE $2 000 000 OTHER L�—" X POLLICYILY I rE�T LOC PRODUCTS 3 COMPIOP ACC $2,000,000 : FF AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT JANYAUTO (Ea accident) $1,000,000 BODILY INJURY(Per Person) AOWNED AUTOS ONLY SAUT�ULED N N 1921426 02/15/2025 02/15/2026 BODILY INJURY(Per Accident) HIRED AUTOS ONLY NON OWNED PROPERTY DAMAGE AUTOS ONLY (Per Accident JUNIBRELLA LIAR XOCCUR EACH OCCURRENCE $1.000,000 AFxcEssLge CLAMS MADEN N 1921428 02/15/2025 02/15/2026 AGGREGATE $1,000,000 DED I RETENTION WORKERS COMPENSATION AND EMPLOYERS'LIABILITY YIN X I PER STATUTE OTHER ANY PROPRIETOR/PARTNER/EXECUTIVE A OFFICERIMEMBER EXCLUDED? N/A N 1921430 02/15/2025 02/15/2026 El EACH ACCIDENT $1,000,000 (Mandatory In NH) If yes,describe under El DISEASE EA EMPLOYEE $1,000,000 DESCRIPTION OF OPERATIONS below El DISEASE POLICY LIMIT $1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached it more space Is required) SEE ATTACHED PAGE CERTIFICATE HOLDER CANCELLATION CITY OF FORT COLLINS 1303 COMMUNITY DEVELOPMENT&NEIGHBORHOOD SERVICES SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED PO BOX 580 BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN FORT COLLINS,CO 80522-0580 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE O 1988-2015 ACORD CORPORATION.All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: AC"Ro LOC#: k.--- ADDITIONAL REMARKS SCHEDULE Page 1 of 1 AGENCY NAMEDINSURED FEDERATED MUTUAL INSURANCE COMPANY HAHN PLUMBING AND HEATING 130 CHESTNUT ST POLICY NUMBER FORT COLLINS,CO 80524-2403 SEE CERTIFICATE#130.3 CARRIER NAIC CODE EFFECTIVE DATE:SEE CERTIFICATE#130.3 SEE CERTIFICATE#130.3 ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: CERTIFICATE OF LIABILITY INSURANCE POLICY COVERAGE AS OF 02/15/2025 ADDITIONAL NAMED INSUREDS INCLUDE HAHN 77 BUSINESS HOLDINGS GROUP LLC RE: LICENSE# H-943 AND #FP-15 ACORD 101 (2008/01) O 2008 ACORD CORPORATION.All rights reserved. The ACORD name and logo are registered marks of ACORD --1 Ar✓ CERTIFICATE OF LIABILITY INSURANCE DATE(Ni 02/17/202 71/202oDIYYYY) 5 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 NAME; CLIENT CONTACT CENTER FEDERATED MUTUAL INSURANCE COMPANY - HOME OFFICE:P.O.BOX 328 (A/C,No,EXt):888-3334949 (A/C,Not:507-446-4664 OWATONNA,MN 55060 E-MAIL ADOREss:CLIENTCONTACTCENTER@FEDINS.COM INSURERS AFFORDING COVERAGE NAIC# INSURER A:FEDERATED MUTUAL INSURANCE COMPANY 13935 INSURED INSURER B: HAHN PLUMBING AND HEATING 130 CHESTNUT ST INSURER C: FORT COLLINS,CO 80524-2403 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:67 REVISION NUMBER:3 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 ADDL SUER POLICY EFF POUCY EXP LTR INSR WVD POLICY NUMBER MMIDDIYYYV MMIDDiYYYYI LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $1,000,000 CLAIMS-MADE OCCUR DAMAGE TO RENTED PREMISES III 111 (Ea aewrrance) $100,000 A N N 1921426 02l15/2025 02/15/2026 MED EXP(Any one person) EXCLUDED PERSONAL S ADV INJURY _ $1,000,000 OENL AGGREGAITE�LIMIT APPLIES PER: GENERAL AGGREGATE $2 OOO OOO OTHER: X POLICY I FRO- ❑LOG LL—IF"ECT PRODUCTS 6 COMPIOP ACC $2,000,000 AUTOMOBILE LIABILITY COMBINED SINGLE OMIT JANYAUTO (Ea awdent) $1,000,000 BODILY INJURY(Par Person)AOWNED AUTOS ONLY AUCTOS HEDULED N N 1921426 02/15/2025 02/15/2026 BODILY INJURY(Per Accident) HIRED AUTOS ONLY NON WINED Q E� PROPERTY DAMAGE (Per Accident) �UMBRELLA LIAR X OCCUR EACH OCCURRENCE $1,000,000 AEXCESS LIAR CLAIMS-MADE N N 1921428 02/15/2025 02/15/2026 AGGREGATE $1,000,000 DED RETENTION WORKERS COMPENSATION AND EMPLOYERS'LIABILITY YIN X PER STATUTE THER ANY PROPRIETOR/PARTNER/EXECUTIVE A OFFICER/MEMBER EXCLUDED? N/A N 1921430 02/15/2025 02/15/2026 E.L EACH ACCIDENT $1,000,000 (Mandatory In NH) If yes,describe under E.I.DISEASE EA EMPLOYEE $1,000,000 DESCRIPTION OF OPERATIONS below E.L DISEASE POLICY LIMIT $1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 1e1,Additional Remarks Schedule,may be attached if more space Is required) SEE ATTACHED PAGE CERTIFICATE HOLDER CANCELLATION CITY OF FOR COLLINS PLANNING DEVELOPMENT$TRANSPORTATION 67 3 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED PO BOX 580 BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN FORT COLLINS,CO 80522-0580 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE J I n O 1988-2015 ACORD CORPORATION.All rights reserved. ACORD 25(2016/03) The ACORD name and log o are registered marks of ACORD r-� AGENCY CUSTOMER ID: ACCRiL�� LOC#: ADDITIONAL REMARKS SCHEDULE Page 1 of 1 AGENCY NAMEDINSURED FEDERATED MUTUAL INSURANCE COMPANY HAHN PLUMBING AND HEATING 130 CHESTNUT ST POLICY NUMBER FORT COLLINS,CO 60524-2403 SEE CERTIFICATE#67.3 CARRIER NAIC CODE EFFECTIVE DATE:SEE CERTIFICATE#67.3 SEE CERTIFICATE#67.3 ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: CERTIFICATE OF LIABILITY INSURANCE POLICY COVERAGE AS OF 02/LS/2025 ADDITIONAL NAMED INSUREDS INCLUDE HAHN 77 BUSINESS HOLDINGS GROUP LLC ACORD 101 (2008/01) O 2008 ACORD CORPORATION.All rights reserved. The ACORD name and logo are registered marks of ACORD