HomeMy WebLinkAboutALPENGLOW SPRINKLER - INSURANCE CERTIFICATECERTIFICATE OF LIABILITY INSURANCE
American Family Insurance Company ❑
American Family Mutual Insurance Company if selection box is not checked.
6000American Pky Madison, Wisconsin 53783-0001
Agent's Name, Address and Phone Number (Agt./Dist.)
Larry D Peterson Agency Inc. (119/309)
149 W Harvard Suite 102
Fort Collins, CO 80525
970-229-9393
Insured's Name and Address:
Alpenglow Sprinkler and Landscaping Inc.
PO Box 1981
Fort Collins, CO 80522
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 oolicies listed below.
COVERAGES
This is to certify that 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.
POLICY TYPE
TYPE OF INSURANCE
POLICY NUMBER
Effective
Expiration
LIMITS OF LIABILITY
Mo,Da ,Yr
Mo,Da ,Yr
Homeowners/
Bodily Injury and Property Damage
Mobilehomeowners Liability
Each Occurrence
Boatowners Liability
Bodily Injury and Property Damage
Each Occurrence
Personal Umbrella Liability
Bodily Injury and Property Damage
Each Occurrence
Farm/Ranch Liability
Farm & Personal Liability Each Occurrence
Farm Employer's Liability Each Occurrence
Statutory
Workers Compensation and
05XB-2137
04/22/2004
04/22/2005
Each Accident 100,000
Employers Liability +
Disease - Each Employee 100,000
Disease - Policy Limit 500,000
General Liability
General Aggregate $ 1,000,000
® Commercial General
05XB-2137
11/11/2004
11/11/2005
Products - Completed Operations Aggregate $ 1,000,000
Liability (occurrence)
Personal and Advertising Injury $ 500,000
❑
Each Occurrence $ 500,000
❑
Fire Damage (Any One Fire) $ 100,000
Medical Expense (Any One Person $ 5,000
Businessowners Liability
Each Occurrence ++
A re ate + +
Automobile Liability
Bodily Injury - Each Person
❑ Owned Autos (Basic form)
Bodily Injury - Each Accident
❑ Owned Autos (Comp form)
Property Damage
❑ Hired Autos
Bodily Injury & Property Damage Combined
❑ Non -owned Autos
❑ Garage liability
Excess Liability
❑ Commercial Blanket Excess
Each Occurrence/Aggregate
DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/RESTRICTIONS/SPECIAL ITEMS
+ The individual or partners shown as Insured "" elected to be
Ladscaping and sprinkler installation
covered as employees under this policy.
+ + Products -Completed Operations aggregate is equal to each
occurrence limit and is included in policy aggregate.
CERTIFICATE HOLDER'S NAME AND ADDRESS
CANCELLATION
® Should any of the above described policies be canceled before the
City of F t Collins
expiration date thereof, the company will endeavor to mail '(10 days) written
PO Box
notice to the Certificate Holder named, but failure to mail such notice shall
Fort Collins, CO 80522
impose no obligation or liability of any kind upon the company, its agents or
representatives. *10 days unless different number of days shown.
❑ This certifies coverage on the date of issue only. The above described
policies are subject to cancellation in conformity with their terms and by the
laws of the state of issue.
DATE ISSUED
AUTHORIZED REPRESENTATIVE
11 /161200,
U-201 Ed. 1196 ORIGINAL - Certificate Holder, COPIES to Services, Insured, Agent Stock No. 06668