HomeMy WebLinkAboutA M LANDSCAPE - INSURANCE CERTIFICATE (4)OP ID A DATE (MM/DD/
ACORD CERTIFICATE OF LIABILITY INSURANCE
A&MLA-1 09 12 03 03
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
390 Union Blvd. #650 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Lakewood CO 80228
Phone: 720-962-0930 Fax:720-962-0942 INSURERS AFFORDING COVERAGE NAIC #
INSURED INSURER A: Allied Insurance Group 42579
INSURER B: Pinnacol Assurance
A & M Landscape, Inc.
Allen Winter INSURERC.
2417 E . Mulberry INSURER D:
Ft. Collins CO 80524
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.
LTPOLICY
R
NSR
TYPE OF INSURANCE
POLICY NUMBER
EFFECTIVE
DATE MM/DD/YY
I POLICY EXPII
DATE MM/DD/YY L�—�_
LIMITS -
GENERAL LIABILITY
EACH OCCURRENCE
$ 1,000,000
PREMISES (Ea occurence)
$100,000
A
X COMMERCIAL GENERAL LIABILITY
ACP7520917911
05/27/03
05/27/04
CLAIMS MADE [K] OCCUR
MED EXP (Any one person)
$ 5,000
PERSONAL & ADV INJURY
$ 1,000,000
GENERAL AGGREGATE
$2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
PRODUCTS - COMP/OP AGG
$2,000,000
POLICY PJERCTO- LOC
A
AUTOMOBILE
LIABILITY
ANY AUTO
ACP7520917911
05/27/03
05/27/04
(EaaccideDISINGLE LIMIT
$ 1 , 000 , 000
X
BODILY INJURY
(Per person)
$
ALL OWNED AUTOS
SCHEDULED AUTOS
�--�i
' X X
BODILY INJURY
HIRED AUTOS
X
NON-OWNEDAUTOS
(Per amdeni)
`
PROPERTYDAMAGE
(Per accident)
$
GARAGE LIABILITY
AUTO ONLY - EA ACCIDENT
$
OTHER THAN EA ACC
$
ANY AUTO
$
AUTO ONLY: AGG
EXCESS/UMBRELLA LIABILITY
EACH OCCURRENCE
$
OCCUR CLAIMS MADE
AGGREGATE
$
$
DEDUCTIBLE
$
RETENTION $
WORKERS COMPENSATION AND
EMPLOYERS'LIABILITY
ANY PROPRIETORIPARTNER/EXECUTIVE
OFFICER/MEMBER EXCLUDED?
If yes, describe under
SPECIAL PROVISIONS below
4061794
09/01/03
09/01/04
X TORY LIMITVvu S VIER
$500,000
E.L. EACH ACCIDENT
E.L. DISEASE - EA EMPLOYEE
$500, 000
E.L. DISEASE - POLICY LIMIT i
$ 500 , 000
OTHER
A
CONTRACTORS EQUIP
7520917911
05/27/03
05/27/04
SCHEDULED $187,955
UNSCHEDUL $ 10,000
OESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS
ALL PROJECTS/ALL LOCATIONS. CERTIFICATE HOLDER IS NAMED AS ADDITIONAL
INSURED EXCEPT FOR WORKERS' COMPENSATION COVERAGE.
iaK I It-IGA I t KULUtK
FTCOL-1
CITY OF FT. COLLINS
PURCHASING OR RISK MGMT.
P.O. BOX 580
FT. COLLINS CO 80522
CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATIOi
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 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. w