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HomeMy WebLinkAboutARMADILLO FENCE - INSURANCE CERTIFICATE (5)CERTIFICATE OF LIABILITY INSURANCE American Family Insurance Company ❑ American Family Mutual Insurance Company if selection box is not checked. 6000 American Pky Madison, Wisconsin 53783-0001 Insured's Name and Address Agent's Name, Address and Phone Number (Agt./Dist.) Armadillo Fence and Security Larry D. Peterson (970) 229-9393 229 N Hwy 287 149 W Harvard Street Ste 102 Fort Collins, CO 80524 Ft. Collins, CO 80525-2186 (119/309) 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 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 rasped to which this certificate may be Issued or may pertain, the insurance afforded by the policies described herein is subject to all the temps, exclusions, and conditions of such policies. TYPE OF INSURANCE POLICY NUMBER POLICY DATE LIMITS OF LIABILITY EFFECTIVE EXPIRATION (Mo. Day. Yr(Mo. Day, Yr Homeowners/ Bodily Injury and Property Damage Mobilehomeowners Liability Each occurrence $ '000 Boatowners Liability Bodily Injury and Property Damage Each Occurrence $ ,000 Personal Umbrella Liability Bodily Injury and Property Damage Each Occurrence $ ,000 Farm Liability a Personal Liability Farm/Ranch Liability Each occurrence $ 000 Farm Employer's Liability Each Occurrence $ 000 Workers Compensation and statutory ++++++++++++ Each Accident $ 000 Employers Liability t Disease - Each Employee $ ,000 Disease - Policy Limit $ ,000 General Liability General Aggregate $ 2,000 000 Products -Com leted Operations Aggregate $ 2,000 ,000 ® Commercial General Liability(occurrence) 1-7Liability 5/21/2004 5/21/2005 Personal and Advertising Injury $ 1,000,000 Each Occurrence $ 1,000 ,000 ❑ Damage to Premises Rented to You $ 100 000 Medical Expense (Any One Person) $ 5 000 Businessowners Liability Each Occurrencet t $ 000 Aggregatett $ ,000 Liquor Liability Common Cause Limit $ ,000 Aggregate Limit $ ,000 Automobile Liability Bodily Injury- Each Person $ 1,000 ,000 ❑ Any Auto IM All Owned Autos Bodily Injury - Each Accident $ 1,000 ,000 ❑ Scheduled Autos 05-XF9663-02-00 5/21/2004 5/21/2005 Property Damage $ ® Hired Auto 1,000,000 ®❑ Nonowned Autos Bodily Injury and Property Damage Combined $ 000 Excess Liability ❑ Commercial Blanket Excess i z ` �' N� °J' �'> f �; EachOoourence/Aggregate $ 64 �, ,000 Other (Miscellaneous Coverages) DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / RESTRICTIONS / SPECIAL ITEMS t The Individual or partners shown as insured ❑ Have ❑ Have not The City of Fort Collins is listed as Additional Insured on the CG 20 10 10 01 endorsement. elected to be covered as employees under this policy. t t Products -Completed Operations aggregate is equal to each occurrence limit and is Included In policy aggregate. CE t1tFlCATE HOLDSFt" _ t1gME'AIMR'ADD iESS CANCELLATION . ADDITIONAL INSURED Should any of the above described policies be cancelled before the expiration date thereof, the company will endeavor to mail'( days) City of Fort Collins written notice to the Certificate Holder named, but failure to mail such PurchasingDept. p notice shall impose no obligation or liability of any kind upon the 'fO company, its agents or representatives. days unless different Attn: John Stephen number of days shown. 215 N Mason Street ® This certifies coverage on the date of issue only. The above Fort Collins, CO 80521 described policies are subject to cancellation in conformity with their terms and by the laws of the state of issue. DATE I UED AUTHORIZED REPRESENTATIVE 9/30/2004 Larry D Peterson U-201 Ed. 5/00 Certificate Holder Stock No. 06668 Rev. 7/02 POLICY NUMBER: COMMERCIAL GENERAL LIABILITY CG 20 1010 01 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED — OWNERS, LESSEES OR CONTRACTORS — SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name of Person or Organization: (if no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) A. Section II — Who Is An Insured is amended to include as an insured the person or organization shown in the Schedule, but only with respect to liability arising out of your ongoing operations performed for that insured. S. With respect to the insurance affordedfo rtlece adr+fionel insure, the lnllgwing exclusion is added: 2. Exclusions This insurance does not apply to 'bodily or'property damage" occurring after. (1) All work, including materials, parts or equipment fumished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the site of the covered operations has been completed; or (2) That portion of 'your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. CG 20 10 10 01 © ISO Properties, Inc., 2001 Stock No. 05781 F CERTIFICATE OF LIABILITY INSURANCE American Family Insurance Company ❑ American Family Mutual Insurance Company if selection box is not checked. 6000 American Pky Madison, Wisconsin 53783-0001 Agent's Name, Address and Phone Number (Agt./Dist.) Larry D Peterson (119/309) 149 W Harvard, Suite102 Fort Collins, CO 80525 970-229-9393 Insured's Name and Address: Armadillo Construction Company 229 N Hwy 287 Fort Collins, CO 80524 This certificate is issued as a matter of information only and confers no rights upon the Certificate Holder. This certificate does not amend_ extend nr altar the envarana airnrda t r..r t:,a nn:: :es rzet...r r...: ... 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 licies. POLICY TYPE TYPE OF INSURANCE POLICY NUMBER LIMITS OF LIABILITY Effective Expiration 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 Employers Liability Each Occurrence Statutory ... . Workers Compensation and Each Accident Employers Liability + Disease - Each Employee Disease - Policy Limit General Liability 05-XF9633 5/21/2004 5/21/2005 General Aggregate $ 2,000,000 ® Commercial General Products - Completed Operations Aggregate $ 2,000,000 Liability (occurrence) ❑ Personal and Advertising Injury $ 1,000,000 Each Occurrence $ 1,000,000 ❑ Fire Damage (Any One Fire) $ 100,000 Medical Expense (Any One Person $ 5,000 Businessowners Liability Each Occurrence ++ Aqqreqate + + Automobile Liability 05-XF9633 5/21/2004 5/21/2005 Bodily Injury - Each Person 1,000,000 x Owned Autos (Basic form) Bodily Injury - Each Accident 1,000,000 ❑ Owned Autos (Comp form) Property Damage 250,000 ❑ Hired Autos Bodily Injury & Property Damage Combined ❑ Non -owned Autos ❑ Garage liability Excess Liability ❑ Commercial Blanket Excess 05-XF9633 5/21/2004 5/21/2005 Each Occurrence/Aggregate 1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/RESTRICTIONS/SPECIAL ITEMS + The individual or partners shown as Insured ••• elected to be covered as employees under this policy. ++ Products -Completed Operations aggregate is equal to each occurrence limit and is included in policy aggregate. CERTIFICATE HOLOEI"s NAME AN©%iCfDRESS ` CANCELLATION City of Fort Collins ® Should any of the above described policies be canceled before the Purchasing expiration date thereof, the company will endeavor to mail '( 10 days) written PO Box 580 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 n not v� •rnc. 6-8-04 C.T ..1.,. �U. vav vtvrarNAL - Vercmcate Holder, COPIES to Services, Insured, Agent Stock No. 06668 ' JUL 01 2004 14:46 FR TO 2216707 P.01/01 ACOR_D_ CERTIFICATE OF P DATE (MMIOD1YY) P I 07/01/04 LIABILITY INSURANCO_ THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION PRODUCER ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Brown & Brown Ina - Ft Collins HOLDER" THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 125 S Howes, 5th Floor ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. P O Box 2226 Fort Collins CO 20522-2226 INSURERS AFFORDING COVERAGE Phofse:970-482-7747 Fax:970-484-4165 mSLIREo �^ INSURER P1Anacol AssurancO INSURER B: Armadillo Fence & security INSURER C: Dallas Collet -' 229 N Higqhway 287 INBURERD: Fort COlIin6 CO 80524 INSURERS: 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 DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND GONOMONS OF SUCH MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ,� - TYPE OF INSURANCE POLICY NUMBER �'p'ERp�� pA MWD DA Ei MMM LIMITS EACH OCCURRENCE ICOMMERCIAL GENERAL LIABILITY FIRE DAMAGE (Arty one fire) I GENERAL LIABILITY ^„ CLAIMS MADE 1.1 OCCUR MED EXP (Ary one Pen) I PERSONAL a ADV INJURY f GENERAL AGGREGATE I GEML AGGREGATE LIMIT APPLIES PER: PRODUCTS ^ COMPlOP AGG I POLICY PRO• LOC JECT AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT S (ER RceideM) ANY AUTO ' ALL OWNED AUTOS BODILY INJURY I (Per person) SCHEDULED AUTOS HIRED AUTOS SODILYINJURY S IPer exloenq NON -OWNED AUTOS PROPERTY DAMAGE I —..... .. (Per adders) Y AUTO ONLY - EA ACCIDENT I OTHERTHAN EA ACC S AUTO ONLY: AGG S EACH OCCURRENCE f CLAIMS MADE [E- AGGREGATE I . f _ s f I WORKERS COMPENSATION AND X TORY LIMITS ER A EMPLOYERS' LIABILITY 4081334 05/20/04 06/01/05 E.L, EACH ACCIDENr s100,000 E,LD19EASE-IiA EMPLOYEE 1100, 000 E.L DISEASE -POLICY LIMIT f 50O O00 OTHER DESCRIPTION OF OPERATIONSILOCATIONSNENICLESIEXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS Fax: 221-6707 CERTIFICATE HOLDER 17 ADDITIONAL INSURED; INSURER LETTER: _ CANCELLATION CI7`YP= SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANC9LLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDFAVOR TO MAIL !.0 OAY9 WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, SLIT FAILURE TO 00 SO SHALL City of Fort Colins IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR P O Box 580 Fort Collins CO 80522 REPRESERTAIrr"A 1111THOR12E0 REPRESENTATIVE ACORD CORP RATION 1988 ACORD 2" (7197) ** TnTAI PArF. R1 **