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HomeMy WebLinkAboutAUTUMN TREE CARE - INSURANCE CERTIFICATE (2)ACORR CERTIFICATE OF LIABILITY INSURANCE 03/01/20o PRODUCER (303)939-9921 FAX (303)939-9926 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Herbert -Leavitt Longmont ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 275 South Main Street HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR Suite 208 Longmont, CO 80501 INSURED Autumn Tree Care LLC 913 E Prospect St Fort Collins, CO 80525 INSURERS AFFORDING COVERAGE INSURERA: Pinnacol Assurance INSURER B: INSURER C: INSURER D: INSURER E: NAIC # THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTW ITHSTANDINi 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 ADDNTYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE (MM/DnNYI POLICY EXPIRATION DATE IMMIDDMn LIMITS GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY CLAIMS MADE OCCUR DAMAGE TO RENTEDPRFMIqFS (Fa $ MED EXP (Any one person) It PERSONAL B ADV INJURY $ GENERAL AGGREGATE $ GENL AGGREGATE LIMIT APPLIES PER: POLICYFICT SE LOC PRODUCTS - COMP/OP AGG $ AUTOMOBILE LIABILITY ANY AUTO COMBINED (Ea acdtlentSINGLE LIMIT $ ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY (Per person) $ HIRED AUTOS NON -OWNED AUTOS BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESSIUMBRELLA LIABILITY OCCUR CLAIMS MADE EACH OCCURRENCE $ AGGREGATE $ DEDUCTIBLE RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY 4065348 01/01/2004 01/01/2005 X WC sTAru- orH- E.L. EACH ACCIDENT $ 100,000 A ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICERIMEMBER EXCLUDED? If yeg AL PR PROVISI SPECIAL PROVISIONS below ONS _T E.L. DISEASE - EA EMPLOYE $ 100Q 00 E.L. DISEASE - POLICY LIMIT $ 500 0Q OTHER DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS ertificate holder is named as additional insured but only as respects the liability arising out of th rk performed by the named insured. City of Fort Collins Purchasing Department John Stephen 215 N. Mason Fort Collins, CO 80525 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE n AL'UKUCOIcUU1/Ui31 rr ; t7/VJccl—O/U/ ©ACORD CORPORATION 1988