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HomeMy WebLinkAboutA M LANDSCAPE - INSURANCE CERTIFICATE (3)ACORD CERTIFICATE OF LIABILITY INSURANCE OP ID DATE(MMIDDIYYYY) A&MLA-1 05 25 04 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Six & Geving/Denver Office HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 225 Union Blvd. #575 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Lakewood CO 80228 Phone: 720-962-0930 Fax:720-962-0942 INSURERS AFFORDING COVERAGE NAIC # INSURED INSURERA: Allied Insurance Group 42579 INSURER B: Pinnacol Assurance A & M Landscape, Inc. Allen Winter INSURER C: 2417 E. Mulberry INSURER D: Ft. Collins CO 80524 INSURER E: rnVFRAr:PR 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, IN*K LTR RUU N INSR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE MMIDDIYY POLICY EXPIRATION DATE MMIDDIYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1 , 000 , 000 A X COMMERCIALGENERAL LIABILITY ACP7530917911 05/27/04 05/27/05 PREMISES (Eeoaurence) $ 100,000 CLAIMS MADE [�(] OCCUR MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $ 1 , 00 0 , 0 00 GENERAL AGGREGATE s2,000,000 GENT AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMPIOP AGG $ 2 , 000 , 0 00 1-7 POLICY PROECT LOC J A AUTOMOBILE LIABILITY ANY AUTO ACP7530917911 05/27/04 05/27/05 COMBINED SINGLE LIMIT (Ea accident) $1 QODQQQ X BODILY INJURY (Per person) $ ALL OWNED AUTOS SCHEDULEDAUTOS X BODILY INJURY (Per accident) $ HIRED AUTOS NON -OWNED AUTOS X PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY AUTO ONLY - EAACCIDENT $ OTHERTHAN EA ACC $ ANY AUTO $ AUTO ONLY: AGG EXCESSIUMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR CLAIMS MADE AGGREGATE $ $ $ DEDUCTIBLE $ RETENTION $ B WORKERS COMPENSATION AND EMPLOYERS'LIABILITY ANY PROPRIETORlPARTNER/EXECUTIVE 4061794 09/01/03 09/01/04 X TORY LIMITS ER E.L. EACH ACCIDENT $ SODr 000 E.L. DISEASE - EA EMPLOYEE $ 500 , 000 OFFICERIMEMBER EXCLUDED? If yes, describe under SPECIAL PROVISIONS below E.L. DISEASE -POLICY LIMIT 1 $500,000 OTHER A Contractors Equip ACP7530917911 05/27/04 05/27/05 Scheduled $295,955 Unschedul $ 10,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS ALL PROJECTS/ALL LOCATIONS. CERTIFICATE HOLDER IS NAMED AS ADDITIONAL INSURED EXCEPT FOR WORKERS' COMPENSATION COVERAGE. l cm I Iri .A I C r1ULUCK UANGtLLA I IUN FTCOL-1 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN CITY OF FT. COLLINS NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL PURCHASING OR RISK MGMT . IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR P.O. BOX 580 FT. COLLINS CO 80522 REPRESENTATIVES. AUTHORIZED REPRESENTATIVE Sandra Aragon ACORD 25 (2001/08) © 49ORD CORPAWTION 1988 ACORD CERTIFICATE OF LIABILITY INSURANCE OP ID DATE(MMIDDIYYYY) A&MLA-1 05 25 04 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Six & Geving/Denver Office HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 225 Union Blvd. #575 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Lakewood CO 80228 Phone: 720-962-0930 Fax:720-962-0942 INSURERS AFFORDING COVERAGE NAIC # INSURED INSURERA: Allied Insurance Group 42579 INSURER B: Pinnacol Assurance A & M Landscape, Inc. Allen Winter INSURER C: 2417 E . Mulberry INSURER D: Ft. Collins CO B0524 INSURER E: f-n%1r DABFS 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 NSR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE MMIDDIYY POLICY EXPIRATION DATE MMIDDIYY LIMITS A GENERAL LIABILITY X COMMERCIALGENERAL LIABILITY CLAIMS MADE [X] OCCUR ACP7530917911 05/27/04 05/27/05 EACH OCCURRENCE $ 1,000,000 PREMISES (Ea occurence) $100,000 MED EXP (Any one person) $ 5,000 PERSONAL B ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: 17 POLICY PECROT LOC J PRODUCTS - COMP/OP AGG $2,000,000 A AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIREDAUTOS NON -OWNED AUTOS ACP7530917911 05/27/04 05/27/05 COMBINED SINGLE LIMIT (Ea accident) $ 1 DDD rDDO X BODILY INJURY (Per person) $ X BODILY INJURY (Per accident) $ X PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY ANY AUTO AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC AUTO ONLY: AGG $ $ EXCESS/UMBRELLA LIABILITY OCCUR CLAIMS MADE DEDUCTIBLE RETENTION $ EACH OCCURRENCE $ AGGREGATE $ $ $ B WORKERS COMPENSATION AND EMPLOYERS'LIABILITY PROPRIETOR/PARTNER/EXECUTIVE OFFICERIMEMBER EXCLUDED? If es, describe under SPECIAL PROVISIONS below 4061794 09/01/03 09/01/04 X TORY wcTTA U- ER LIMANY E.L. EACH ACCIDENT $500r OOO E.L. DISEASE - EA EMPLOYEE $500, 000 E.L. DISEASE -POLICY LIMIT I $50D 000 A OTHER Contractors Equip ACP7530917911 05/27/04 05/27/05 Scheduled $295,955 Unschedul $ 10,000 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS ALL PROJECTS/ALL LOCATIONS. CERTIFICATE HOLDER IS NAMED AS ADDITIONAL INSURED EXCEPT FOR WORKERS' COMPENSATION COVERAGE. %,rM I IrH.A I C rIVLUCK GANGELLATIUN FTCOL-2 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATIOI DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN CITY OF FT. COLLINS NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL FORESTRY DIVISION 281 N . COLLEGE IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR FT. COLLINS CO 80521 REPRESENTATIVES. ACORD 25 (2001108) ©AICORD CORPORATION 1988 i,