HomeMy WebLinkAbout125758 FULLER LANDSCAPING - INSURANCE CERTIFICATE (3)ACORDM CERTIFICATE OF LIABILITY INSURANCE 04/2 /2007
PRODUCER (970)223-0924 FAX (970)267-2231 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Colorado BW Insurance Agency, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
1075 W Horsetooth Rd, Ste 106 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Fort Collins, CO 80526
INSURERS AFFORDING COVERAGE NAIC #
INs Fuller Landscaping, LLC INSURER A: Colorado Casualty Insurance 41785
4836 Kiva Drive INSURER B.
Laporte, CO 80535 INSURER C:
INSURER 0:
INSURER E:
COVERAGE
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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
ILTRNSR
D,DN
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
DATE IMWDDIYYI
POLICY EXPIRATION
DATE (MLVDDfYYi
LIMITS
GENERAL LIABILITY
AP053542706
04/24/2007
04/24/2008
EACH OCCURRENCE
$ 1,000,00
X COMMERCIAL GENERAL LIABILITY
DAMAGE TO RENTED
$ 50' 00
CLAIMS MADE r OCCUR
MED EXP (Any one person)
$ 5 r 00
A
T--
PERSONAL & ADV INJURY
$ 1,000,000
GENERAL AGGREGATE
$ 2,000,000
GENT AGGREGATE LIMIT APPLIES PER:
PRODUCTS - COMP/OP AGG
$ 2,000,000
POLICY PRO LOC
JECT
AUTOMOBILE
LIABILITY
ANY AUTO
COMBINED SINGLE LIMIT
(Ea accident)
$
ALL OWNED AUTOS
SCHEDULED AUTOS
BODILY INJURY
(Per person)
$
HIRED AUTOS
NON -OWNED AUTOS
BODILY INJURY
(Per accident)
$
PROPERTY DAMAGE
(Per accident)
$
GARAGE LIABILITY
AUTO ONLY - EA ACC IDENT
$
ANY AUTO
OTHER THAN EA ACC
$
AUTO ONLY: AGG
$
EXCESS/UMBRELLA LIABILITY
OCCUR CLAIMS MADE
EACH OCCURRENCE
$
AGGREGATE
$
DEDUCTIBLE
RETENTION $
$
WORKERS COMPENSATION AND
WC STATU- )TH-
EMPLOYERS' LIABILITYFR
E.L. EACH ACCIDENT
$
ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICER/MEMBER EXCLUDED?
If yes, describe under
E. L. DISEASE - EA EMPLOYEE
$
E.L. DISEASE - POLICY LIMIT
$
SPECIAL PROVISIONS below
OTHER
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS
City of Fort Collins
215 N Mason St. 2nd Floor
PO Box 850
Fort Collins, CO 80522
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL
10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,
BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY
OF ANY KIND UPON THE SU ER, ITS AGENTS OR REPRESENTATIVES
AUTHORIZED REPRESENTA A A
ACORD 25 (2001108)
rf)RPnRATInIJ 4022
IMPORTANT
If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement
on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
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).
DISCLAIMER
The Certificate of Insurance on the reverse side of this form does not constitute a contract between
the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it
affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon.
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