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Home My WebLink AboutCLARK ENTERPRISES - INSURANCE CERTIFICATEACORn CERTIFICATE OF LIABILITY INSURANCE OP ID DATE I MMIDDIYYYY) CLAE002 10/08/07 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Forsberg Engerman Company HOLDER THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 3575 S Sherman St ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW Englewood CO 80113 Phone 303-762-1717 INSURERS AFFORDING COVERAGE NAIC # INSURED INSURERA Plnnacol Assurance INSURER B Clark Enterprises Construction Company INsuRERc 80 Factory Road INSURER D Eaton CO B0615-3481 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 INSRWD9 LTR INSR TYPE OF INSURANCE P LICYEFFECTIVE POLICY NUMBER DATE MMIDDIYY POLICY EXPIRATION DATE MMIDDIYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ COMMenCIA�bENcnnrLlABaITi DAMAGETORENTED— PPEP'S«(Ee seen encel_ $ CLAIMS MADE CCCUR MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ GENLAGGREGATE LIMITAPPLIES PER PRODUCTS COMPIOPAGG $ POLICY JEEND LOC AUTOMOBILE LIABILITY ANY AUTO COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) $ ' ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY (Per accident) $ HIRED AUTOS NON OWNED AUTOS PROPERTY DAMAGE (Per accident) - $ __ GARAGE LIABILITY AUTO ONLYEAACCIDENT $ OTHER THAN EA ACC $ ANY AUTO $ AUTO ONLY AGG EXC ESSIUMBRELIA LIABILITY EACH OCCURRENCE $ AGGREGATE $ OCCUR CLAIMS MADE $ DEDUCTIBLE $ RETENTION $ WORKERS COMPENSATION AND X TORYLIMITS ER EL EACH ACC DENT - __-- EL DISEASE EALMPLOYEL s 100000 -- $ 100000 A EMPLOYERS LIABILITY R20FR�d02-1—NE'LXECU^1- OFFICERIMEMBEREXCLUDED'I 2330070 10/01/07 10/01/08 It yes tles",be urnter BPECIALPRGVISIONS below EL DISEASE -POLICY LIMIT $500000 OTHER DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS WWI del d l d riL\A y!pal ■old[ Ne\0(N�AAGLI�IC FTCOLLI 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 City Of Fort Collins 300 LaPorte Avenue IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR Fort Collins CO 80521-2719 REPRESENTATIVES AUT IZE REPRE NTATIVE AGORD 25 (200V08) e ACORD CORPORATION 1988 ACORDTr CERTIFICATE OF LIABILITY INSURANCE 10/11/o,°'""""' 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 THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW ALTER P O Box 270370 Fort Collins, CO 80527 INSURERS AFFORDING COVERAGE NAIC # INSURED Patrick Plumbing & Heating, L L C 3600 Horsetooth Court Fort Collins, CO 80526 INSURERA United Fire & Cas INSURER B INSURER G 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 ATE IMMIDDIYYE POLICYDATEMMIDDIYYN LIMITS A GENERAL LIABILITY 60073860 10/01/07 10/01/08 EACH OCCURRENCE $1000000 X COMMERCIAL GENERAL LIARH IY CLAIMS MADE Ly OC( UP PREMISDAMAGEES ( Ea adRENTED current $100OOO MED EXP (Any one person) $5 000 PERSONAL & ADV INJURY $1 00O 000 X PD Ded 1,000 GENERAL AGGREGATE $2 000 000 GEN L AGGREGATE LIMIT APPLIES PER PRODUCTS COMP/OPAGG $2000000 POLICY JECT LDC A AUTOMOBILE LIABILITY ANY AUTO 60073860 10/01/07 10/01/08 COMBINED SINGLE LIMIT (Ea accident) $1 000,000 X BODILY INJURY (Per person) $ ALL OWNED AUTOS SCHEDULED AUTOS X BODILY INJURY (Per accident) $ HIRED AUTOS NON OWNED AUTOS X PROPERTY DAMAGE (Per accbenp $ GARAGE LIABILITY AUTOONLY EAACCIDENT $ OTHER THAN EA ACC $ ANY AUTO $ AUTO ONLY AGG A EXCESSIUMBRELLALIABILITY 60073860 10/01/07 10/01/08 EACH OCCURRENCE $1000000 X I OCCUR 171 CLAIMS MADE AGGREGATE $1 000 O00 S DEDUCTIBLE $ X RETENTION $ 10000 _ WORKERS COMPENSATION AND WC STATU OTH EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNERIEXECUTIVE EL EACH ACCIDENT $ EL DISEASE EA EMPLOYEE $ OFFICERIMEMBER EXCLUDED' If yes describe under SPECIAL PROVISIONS below EL DISEASE POLICY LIMIT $ OTHER DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS Certificate holder is named as additional insured, but only as respects liability arising out of ongoing operations of the named insured (Excluding Workers' Compensation) City of Fort Collins PO Box 580 Ft Collins . CO 80522 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE I EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL _3n 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 ACORD 25 (2001/08) 1 of 2 #M396392 DXS Q 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 msurer(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 AGORO 25-5 (2UU1/OS) 2 of 2 #M396392