HomeMy WebLinkAboutHIGH PLAINS MECHANICAL - INSURANCE CERTIFICATE (3)ACORD
CERTIFICATE OF
LIABILITY INSURANCF� OP ID 82
DATE (M
GH 13
12/2222/04
PRODUCER
Brown & Brown Inc - Ft Collins
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
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
INSURER A: MOUNTAIN STATES MUTUAL
High
Inc.
Plains Mechanical Service
INSURERS: PINNACOL ASSURANCE
INSURER C:
Attn: Judy Auer
2020 Airway Avenue
Ft. Collins CO 80524
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
TYPE OF INSURANCE
POLICY NUMBER
P LI IVE
DATE MM/DD/YY
XPI TI
DATE MM/DD/YY
LIMITS
A
GENERAL LIABILITY
X COMMERCIAL GENERAL LIABILITY
CLAIMS MADE FX1 OCCUR
CPP007999803
12/31/04
12/31/05
EACH OCCURRENCE
$ 1, OOO , OOO
FIRE DAMAGE (Any one fire)
$100,000
MED EXP (Any one person)
$ 10,000
PERSONAL& ADV INJURY
$1,000,000
GENERAL AGGREGATE
$2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
POLICY F PRO LOC
JECT
PRODUCTS -COMP/OP AGG
$ 2 , 000,000
A
AUTOMOBILE
LIABILITY
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON -OWNED AUTOS
BAP007999803
12/31/04
12/31/05
COMBINED SINGLE LIMIT
(Ea accident)
$ 10000 00
X
BODILY INJURY
(Per person)
$
BODILY INJURY
(Per accident)
$
PROPERTY DAMAGE
(Per accident)
$
GARAGE LIABILITY
ANY AUTO
AUTO ONLY - EA ACCIDENT
$
OTHER THAN EA ACC
AUTO ONLY: AGG
$
$
A
EXCESS LIABILITY
X OCCUR CLAIMSMADE
DEDUCTIBLE
X RETENTION $ 10000
UMB007999803
12/31/04
12/31/05
EACH OCCURRENCE
$ 1,000,000
AGGREGATE
$ 1, 000 , QQQ
$
B
WORKERS COMPENSATION AND
EMPLOYERS'LIABILITY
4052379
04/01/04
04/01/05
'ATU
X TORY LIMITS ER
E.L. EACH ACCIDENT
s500,000
E. L. DISEASE - EA EMPLOYEE
$500,000
E.L. DISEASE - POLICY LIMIT
$ 500000
OTHER
I
DESCRIPTION OF OPERATIONSILOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
Fax: 224-6134
City of Fort Collins
Attn: John Stevens
Building & Inspect Div
P O Box 580
Fort Collins CO 80522
CITYFTC SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATIO!
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL -1-0-- 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. n /\
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