HomeMy WebLinkAboutHIGH PLAINS MECHANICAL - INSURANCE CERTIFICATE (4)acoRv CERTIFICATE OF LIABILITY INSURANCE DP ID B2 °A°°
Gx-13 04/0 04/O1/O5
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Brown & Brown Inc - Ft Collins ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
125 S Howes, 5th Floor HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
P O Box 2226 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Fort Collins CO 80522-2226
Phone: 970-482-7747 Fax: 970-484-4165 INSURERS AFFORDING COVERAGE
INSURED
High Plains Mechanical Service
Inc.
Attn: Judy Auer
2020 Airway Avenue
Ft. Collins CO 80524
COVERAGES
INSURER A: MOUNTAIN STATES MUTUAL
INSURER B: PINNACOL ASSURANCE
INSURER C:
INSURER D:
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
LTR
rypE OF INSURANCE
POLICY NUMBER
LI Y EFFE TIVE
DATE MMIDDIYY
POLICY
DATE MM/DDIYY
LIMITS
GENERAL LIABILITY
EACH OCCURRENCE
$ 1 , Q 00 , 000
A
X COMMERCIAL GENERAL LIABILITY
CPP007999803
12/31/04
12/31/05
FIRE DAMAGE (Anyone fire)
$100,000
CLAIMS MADE ❑X OCCUR
MED EXP (Any one person)
$ 10 , 000
PERSONAL &ADV INJURY
$ 1, 000 , 000
GENERAL AGGREGATE
s2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
PRODUCTS - COMP/OP AGG
$2,000,000
POLICY PRO LOC
JECT
A
AUTOMOBILE
LIABILITY
ANY AUTO
BAP007999803
12/31/04
12/31/05
COMBINED SINGLE LIMIT
(EaCO accident)
$ 1 000 QQQ
r r
X
ALL OWNED AUTOS
SCHEDULED AUTOS
BODILY INJURY
(Par person)
$
BODILY INJURY
(Per accident)
$
HIRED AUTOS
NON -OWNED AUTOS
PROPERTY DAMAGE
(Per accident)
$
GARAGE LIABILITY
AUTO ONLY - EA ACCIDENT
$
ANY AUTO
OTHER THAN EA ACC
$
$
AUTO ONLY: AGG
EXCESS LIABILITY
A7X]OCCUR [7CLAIMSMADE
UMB007999803
12/31/04
12/31/05
EACH OCCURRENCE
$ 1 , 000 , 000
AGGREGATE
$1,000,000
DEDUCTIBLE
X RETENTION $ 10000
$
B
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY
4052379
04/01/05
04/01/06
X TORY ILAILI T
ER
E.L. EACH ACCIDENT
$500,000
E.L. DISEASE - EA EMPLOYEE
s500,000
E.L. DISEASE -POLICY LIMIT
$500 000
OTHER
DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS
Fax: 224-6134
City of Fort Collins
Attn: John Stevens
Building & Inspect Div
P O Box 580
Fort Collins CO 80522
CITYFTC I SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATI<
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
IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
REPRESENTATIVES.
ACORD 25-S