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Client#: 39557
ACORDTM CERTIFICATE OF LIABILITY INSURANCE
$D12TE( MIDD/YYYY)
PRODUCER
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Flood & Peterson Insurance Inc
4821 Wheaton Drive
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
P O Box 270370
Fort Collins, CO 80527
INSURERS AFFORDING COVERAGE
NAIC #
INSURED
L & L Landscape, Inc.
LRD, Inc. dba
P O Box 62
Windsor, CO 80550
INSURER A: United Fire & CaS.
INSURER B: Pinnacol Assurance
INSURER C:
INSURER D:
INSURER E:
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.
LTR
NSR
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
DATE MMIDD/YY
POLICY EXPIRATION
DATE MM/DDIYY
LIMITS
A
GENERAL LIABILITY
60066660
04/20/07
04/20/08
EACH OCCURRENCE
$1 00Q 000
X COMMERCIAL GENERAL LIABILITYre
DAMAGE TO RENTED
ncel
$1 00 000
CLAIMS MADE OCCUR
MED EXP (Any one person)
$5 000
PERSONAL & ADV INJURY
$1 00Q 000
X PD Ded:250
GENERAL AGGREGATE
s2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
PRODUCTS - COMP/OP AGG
s2,000,000
POLICY PRO LOC
JECT
A
AUTOMOBILE LIABILITY
ANY AUTO
60066660
04/20/07
04/20/08
COMBINED SINGLE LIMIT
(Ea accident)
$500 ,000
BODILY INJURY
(Per person)
$
ALL OWNED AUTOS
X SCHEDULED AUTOS
X HIRED AUTOS
X NON-OWNEDAUTOS
BODILY INJURY
(Per accident)
$
PROPERTY DAMAGE
(Per accident)
$
GARAGE LIABILITY
AUTO ONLY - EA ACCIDENT
$NY
OTHER THAN EA ACC
$
AUTO A
$
AUTO ONLY: AGG
EXCESS/UMBRELLA LIABILITY
EACH OCCURRENCE
$
AGGREGATE
$
OCCUR CLAIMS MADE
$
DEDUCTIBLE
$
RETENTION $
B
WORKERS COMPENSATION AND
4032758
0$/01/07
08/01/08
X WCSTATU- OTH-
EMPLOYERS' LIABILITY
E.L. EACH ACCIDENT
$'I 000 000
ANY PROPRIETOR/PARTNER/EXECUTIVE
E.L. DISEASE - EA EMPLOYEE
$1,000,000
OFFICER/MEMBER EXCLUDED?
If yes, describe under
E.L. DISEASE - POLICY LIMIT
$ 1000,000
SPECIAL PROVISIONS below
OTHER
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT 1 SPECIAL PROVISIONS
bo 5911
Certificate holder is named as additional insured (Excluding workers
(See Attached Descriptions)
City of Fort Collins
Purchasing Dept.
P O Box 580
Ft Collins , CO 80522
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 1_ DAYS WRITTEN
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
AUTHORIZED REPRESENTATIVE y-
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^��'�� %. —, 1 oT s 3F11)st$Vz0U/Mstsaz5[ SXC 0 ACORD CORPORATION 1988
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.
--w- %— vul Z OT s ;M092MM3139257
DESCRIPTIONS (Continued from Page 1)
compensation).
The following cancellation conditions always apply:
-10 days for non-payment of premium
- If policy shown, 10 days for Workers' Compensation for fraud; material
misrepresentation; non-payment of premium; other reasons approved by the
Commissioner of Insurance