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Home My WebLink AboutHIGH PLAINS MECHANICAL - INSURANCE CERTIFICATE (5)MAY 04 2004 09:52 FR TO 2216707 P.01i01 mm a CERTIFICATE OF LIABILITY INSURANCE OP D s GH-i3 TE (MMIDOMY) °A05/0410 o5/aa/oa PRODUCER Brown a Brown Inc - Ft Collins 125 S Howes, 5th Floor P 0 Box 2226 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE Fort Collins CO $0522-2226 Phone:970-482-7747 Fax:970-484-4165 INSURED INSURERA MOUNTAIN STATES MUTUAL INSURER8: PINNACOL ASSURANCE - High Plains Mechanical Systems Attn : Judy Auer Ft. Col 24 ?011nODBD9 INSURER c: INSURERD: INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REOUtREMENT, 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 16 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 TE MMIDDIYY DATE MOONY LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY . CLAIMS MADE FX] OCCUR CPP007999802 12/31/03 12/31/04 EACH OCCURRENCE S 1 , 000 , 000 FIRE DAMAGE (Any omfv.) $ 10O 000 MED EXP (Any ona pwr ) $ l OA 00 PERSONAL 5 ADV INJURY $ 1 0 000-L000 _ y — GENERAL AGGREGATE 52,000 000 GENL AGGREGATE LIMIT APPLIES PER: POLICY — ACT LOC PRODUCTS -COMPIOP AM s2,000,.000 A AUTOMOBILE X LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULEDAUTOS HIRED AUTOS NON•OWNEDAUTOS .-.._ BAP007999802 12/31/03 12/31/04 COMBINED SINGLE LIMIT (Edamldwt) $1,000,000 $ $ BODILY INJURY (Pa, pmm) BODILY INJURY^ (Par aec4aN) PROPERTY DAMAGE (PAN Imam) $ ,.._.-- GARAGE LIABILITY ANY AUTO AUTO ONLY -EA ACCIDENT $ $ OTHERTHAN EAACC AUTOONLY Amy $ A EXCESS LIABILITY X-]OCCUR�CLAIMSMAOE _ DEDUCTIBLE X RETENTION $ 10000 UbMO07999802 12/31/03 12/31/04 EACH OCCURRENCE $1,000,000 AGGREGATE $2,000,000 S S_—_^ S B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY 4052379 04/01/04 04/01/05 TORY LIMIT6 ER _ $500,000 _X_ E.L. EACH ACCIDENT E.LDISEASE-'EA EMPLOYEE _ $5OO 000 E.L. DISEASE - POLICYLIMIT $500 000 OTHER DESCRIPTION OF OPERATIONSILOCATIONSNEHICLES!EXCLUSIONS ADDED BY ENDORSEME TISPECIAL PROVISIONS Fax: 221-6707 "In lieu of previous sent" CERTIFICATE HOLDER 1N1ADDITIONAL INSURED; INSURER LETTER; CANCELLATION City of Fort Collins Attn: John Stevens Building & Inspect Div P O Sox 580 Fort Collins CO 80522 CI9'YFTC SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATIO DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 1.Q-..- DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO $MALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES (7197) ** TnTC]I PQrF 11 ** ACORD CERTIFICATE OF LIABILITY INSURANCE OPID B2 DATE(MM/DD/YYI GH-13 03/29/04 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 INSURERA: MOUNTAIN STATES MUTUAL INSURER B: PINNACOL ASSURANCE High Plains Mechanical Systems Attn: Judy Auer 2020 Airway Avenue Ft. Collins CO 80524 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. INSR LTR TYPE OF INSURANCE POLICY NUMBER —POLICY FECTIVE EFFECTIVE DALE MMI Y XPI DATE MXMIRA Y LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS MADE 1 ': OCCUR CPP007999802 12/31/03 12/31/04 EACH OCCURRENCE $ 1 , 000 , 000 FIRE DAMAGE (Any one fire) $ 100, 000 MED EXP (Any one person) $ 10 , 000 PERSONAL& ADV INJURY Is 1, 000, 000 GENERAL AGGREGATE s2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY 7 PRJECOT LOC PRODUCTS - COMP/OP AGG $2,000,000 A AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS BAP007999802 12/31/03 12/31/04 COMBINED SINGLE LIMIT (Ea accident) $ 1 000 0 00 r r $ 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 E7]CLAIMSMADE DEDUCTIBLE X RETENTION $ 10000 UNB007999802 12/31/03 12/31/04 EACH OCCURRENCE $ 1,000,000 AGGREGATE $1,000,000 $ B WORKERS COMPENSATION AND EMPLOYERS'LIABILITY 4052379 04/01/04 04/01./05 X WTS LIMITS OTH- TORY ER E.L. EACH ACCIDENT $5001000 E. L. DISEASE - EA EMPLOYEE $ 500,000 E.L. DISEASE -POLICY LIMIT $500, 000 OTHER DESCRIPTION OF OPERATIONSILOCATIONSfVEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS Fax: 221-6707 CER I Irk -A I E MULIJCK I N ADDITIONAL INSURED; INSURER LETTER: CANCELLATION CITYFTC SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION City of Fort Collins DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL _1D__ DAYS WRITTEN Attn : John Stevens NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL Building inspect Div P O Box 5 80 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR Fort Collins CO 80522 REPRESENTATIVES. A A REPRESENTATIVE 25-S (7197)