HomeMy WebLinkAboutCMS MECHANICAL SERVICES - INSURANCE CERTIFICATE (2)ACM CERTIFICATE OF LIABILITY INSURANCE OP ID
DATE(MMIDDIYYYY)
COMEC-1
05 17 04
PRODUCER
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Linden/Bartels & Noe Agency GR
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
3459 W 20th Street Suite 224
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Greeley CO 80634
Phone:970-356-1133 Fax:970-356-4088
INSURERS AFFORDING COVERAGE
NAIL#
INSURED
INSURER A: Mountain States Insurance Grp
INSURERS: Pinnacol Assurance
INSURER C:
CMS Mechanical Service �4 1 Inc.
609 TechnoloQggyy Circle 1A
Windsor CO 80550
INSURER D:
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 IMTH 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.
INDK
LTR
RUV
IINSR
TYPE OF INSURANCE
POUCY NUMBER
POLICY EFFECTIVE
DATE MMIDDIYY
POLICY EXPIRATION
DATE MWDDIVY
LIMITS
A
GENERAL LIABILITY
X COMMERCIAL GENERAL LIABILITY
CLAIMS MADE FX] OCCUR
BINDER
04/27/04
04/27/05
EACH OCCURRENCE
$ 1 r 000 r 000
PREMISES(Es occurenos)
$100,000
MED EXP (Any one person)
$ 10 r 000
PERSONAL & ADV INJURY
S1,000,000
GENERAL AGGREGATE
s2,000,000
GENT AGGREGATE LIMIT APPLIES PER:
POLICY PROJECT LOC
PRODUCTS - COMPIOP AGG
$2r000r000
A
AUTOMOBILE
LIABILITY
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIREDAUTOS
NON -OWNED AUTOS
BINDER
04/27/04
04/27/05
COMBINED SINGLE LIMIT
(Ea eccidenq
$ 1 000 000
r r
X
BODILY INJURY
(Per person)
$
X
BODILY INJURY
(Per accident)
$
X
PROPERTY DAMAGE
(Per accident)
$
GARAGE LIABILITY
ANY AUTO
AUTO ONLY -FA ACCIDENT
$
OTHER THAN EA ACC
AUTO ONLY: AGG
$
$
A
EXCESSIUMBRELLA LIABILITY
X I OCCUR F-1 CLAIMS MADE
DEDUCTIBLE
RETENTION $
BINDER
04/27/04
04/27/05
EACH OCCURRENCE
$ 1 r 000 r 000
AGGREGATE
$1,000,000
$
$
B
WORKERS COMPENSATION AND
EMPLOYERS'LIABILITY ANY PROPRIETORIPARTNER/EXECUTIVE
OFFICER/MEMBER EXCLUDED?
It yee, describe under
SPECIAL PROVISIONS below
4008656
06/01/04
06/01/05
X TORY LIMITS ER
E.L. EACH ACCIDENT
$100r 000
E.L. DISEASE - EA EMPLOYEE
$ 100 r 000
E.L. DISEASE -POLICY LIMB
I $ 50 0 000
OTHER
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT! SPECIAL PROVISIONS
CERTIFICATE HOLDER CANCELLATION
FTCOLLP
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 Fort Collins
Purchasing Department
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
P O BOX 580
REPRESENTATIVES.
Fort Collins CO 80521
AU RIZ REPRES R, t , ! c
AD 1Auu-uuc) V ACORD CORPORATION 1988