Loading...
HomeMy WebLinkAbout116732 ENVIROPEST - INSURANCE CERTIFICATEMAY-15-2007 15:10 From: TO:Cittj of Fort Collins P.1/2 ACORD CERTIFICATE OF LIABILITY INSURANCE OP ID DATE(MWDDIYYYY) ENVIR-3 OS 15 07 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE LEIN Insurance Agency HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 4848 Thompson Pkwy ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Johnstown CO 80534 Phone:970-635-9400 Fax:970-635-9401 INSURERS AFFORDING COVERAGE NAIL# INSURED INSURER A: Pinnacol Assurance RPD Services Ina INSURER B DBA Enviropest AKA. Tri City Peat NSURERC 9249 Eastman Park Drive INSURER 0. Windsor CO nO Par INSURER E. THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REOUIRFMENT, 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. LTR NSR TYPE OF INSURANCE POLICY NUMBER DATE UNIDO CYEFFECTIVE PDATE MMIDD/YY LIMITS GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY CLAIMS MADE DOCCUR EACH OCCURRENCE S PREMISES Ea occurence S MED EXP (Any one person) $ PERSONAL S ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: POLICYF71 PRO- JECT LOC PRODUCTS - COMP/OP AGG $ AUTOMOBILE UABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per Parson) $ BODILY INJURY (Per accident) S PROPERTY DAMAGE (Per accdent) S GARAGE UABIUTY ANY AUTO AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC AUTO ONLY. AGG $ S EXCESSIUMBRELLA LIABILITY OCCUR CLAIMS MADE DEDUCTIBLE RETENTION S EACH OCCURRENCE S AGGREGATE $ S $ $ A WORKERS COMPENSATION AND YERS'UABIUTV ANY PROPRIETOR/PARTNER/EXECUTIVE ANY OFFICER/MEMBER EXCLUDED? It ggas, describe under SPECIAL PROVISIONS below 2237922 06/01/07 06/01/08 %{ TORY LIMITS ER EL.EACH ACCIDENT $570 000 r E.L. DISEASE -EA EMPLOYEE $500 Oro E.L. DISEASE -POLICY LIMIT IS500 000 OTHER DESCRIPTION OF OPERATIONS I LOCATION& 1 VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS NIXOFFI 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 DO SO SHALL Nix 0£f ice IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR Attn: John Stephen 1745 Hoffman Mill Rd. REPRESENTATIVES. Fort Collins CO 80524 Au RIB REPRES ACORD 25 (2001108) MRY-15-2007 15:10 From: To:City of Fort Collins P.2�2 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. 05/21/07 ConfirmNet -> 19702216707 Pg 2/4 ACORD. CERTIFICATE OF LIABILITY INSURANCE 5/21 MDDIYY) os/a1/a7 PRODUCER LIC #0352275 1-415-541-7900 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Wells Fargo of CA Ins. Services Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 45 Fremont Street ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Suite 800 San Francisco, CA 94105 INSURERS AFFORDING COVERAGE Michael Garza INSURED INSURER A: American Automobile Insurance Company EnviroPest RPD Services, Inc. INSURERS: 9249 Eastman Park Drive INSURERC Unite A Windsor, CO 80550 INSURER D: inici loco r_. COVERAGES 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. INSR R TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE (MMIDDIYYI POLICY EXPIRATION DATEYY LIMITS A GENERAL LIABILITY MZG80863125 09/01/06 09/01/07 EACH OCCURRENCE $1,000,000 FIRE DAMAGE (Any one trot $1, 000, 000 X COMMERCIAL GENERAL LIABILITY CLAIMS MADE r—xl OCCUR MED EXP (Any me person) $ 10 , 000 PERSONAL It ADV INJURY $1,000,000 X WDO/I Inspections X Pesticide/Herbicide GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $2,000,000 X POLICY PRO LOC AUTOMOBILE LIABILITY ANY AUTO COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) $ ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY (Per accident) $ HIREDAUTOS NON -OWNED AUTOS PROPERTYDAMAGE (Per accident) $ GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC $ ANY AUTO $ AUTO ONLY: AGO EXCESS LIABILITY EACH OCCURRENCE $ AGGREGATE $ OCCUR CLAIMS MADE $ $ DEDUCTIBLE $ RETENTION $ WORKERS COMPENSATION AND EMPLOYERS'LIABILITY WC I -I MITS ER R E TORY LMIT E.L. EACHACCIDENT $ EL DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT $ OTHER DESCRIPTION OF OPERATIONS/LOCATIONSIVEHICLESIEXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS Regarding all CO locations and operations, Certificate Holder is included as Additional Insured pursuant to the attached policy endorsement. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION NIX OFFICE DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL SOHN STEPHEN - PURCHASING DEPT. 1745 ROFFMAN MILL RD IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. FORT COLLINS, CO 80524 AUTHORIZED REPRESENTATIVE USA Arnon oc_c ��ro�i .s.,....... / ., ......,............... r........,... bzsyUzd 05/21/07 ConfirmNet -> 19702216707 Pg 3/4 POLICY NUMBER: Mzce0863125 COMMERCIAL GENERAL LIABILITY CG 2010 07 04 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Or anization s : Locations Of Covered Operations NIX OFFICE, CITY OF FORT COLLINS All Colorado Locations Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II — Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by: 1. Your acts or omissions; or 2. The acts or omissions of those acting on your behalf; in the performance of your ongoing operations for the additional insured(s) at the location(s) desig- nated above. B. With respect to the insurance afforded to these additional insureds, the following additional exclu- sions apply: This insurance does not apply to "bodily injury" or "property damage" occurring after: 1. All work, including materials, parts or equip- ment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the location of the covered operations has been completed; or 2. That portion of "your work" out of which the injury or damage arises has been put to its in- tended use by any person or organization other than another contractor or subcontractor en- gaged in performing operations for a principal as a part of the same project. CG 20 10 07 04 © ISO Properties, Inc., 2004 Page 1 of 1 13 05/21/07 ConfirmNet -> 19702216707 Pg 4/4 I SUPPLEMENT TO CERTIFICATE OF INSURANCE I DATE I os/aI/a7 Envi r oPes t RPD Services, Inc. 05/21/07 ConfirmNet -> 19702216707 Pg 1/4 Fax NIX OFFICE Fax: 1-970-221-6707 Attn: JOHN STEPHEN - PURCHASING DEPT. FROM: EnviroPest RPD Services, Inc. Phone: 1-970-674-0481 Wells Fargo of CA Ins. Services Inc. Agency: Phone: 1-415-541-7900 SUbjeCt EnviroPest - Delivery by CertificatesNow This document was brought to you by CertificatesNow. I£ you have questions regarding the content of this document, please contact the Producer/Agent listed on the certificate of insurance or the Insured listed on the notice of cancellation/reinstatement. To find out how you can send and receive all of your certificates of insurance either by email, high speed fax or standard mail, email customercare@confirmnet.com, or visit our website at www.conf irmnet. cam cc: NIX OFFICE (FAX), The data included in this notice and in the attached document is confidential to ConfirmNet and the party responsible for bringing you this information. Powered ByCertificatesNow'"