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Home My WebLink About102136 KORBY LANDSCAPE LLC - INSURANCE CERTIFICATE (10)A_COR_v_ TM CERTIFICATE OF LIABILITY INSURANCE DATE 04/23/2004 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Heritage General Agency, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 9250 E. Costilla Avenue, Suite 650 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR Englewood CO 80112 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW._ INSURED Korby Landscape, LLC P 0 Box 989 Wellington CO 80549 ___ __ INSURERS AFFORDING COVERAGE INSURER A: -Scottsdale Insurance COmpannnnnnnn� INSURER B INSURER D: THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITH- STANDING 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. iris-- -- _-- _-- __- -- - --._ -- POLI YEFTIVEPOLICY XPRATION _—. ---- LT TYPE OF INSURANCE POLICY NUMBER DATE MM/DD/YY DATE MM/DD/YY L LIMITS GENERAL LIABILITY ACH OCCURENCE $1 000,000 A I X (COMMERCIAL GENERAL LIABILITY CLS0955782 11 /08/2003 11 /08/2004 IRE DAMAGE (Any one fire). _ $100,000 _ (CLAIMS MADE X IIOCCUR — MED EXP (Any one person) _ _ $'5,000 ERSONAL & ADV INJURY $ 1 000,000 $2,000,000 ENERAL AGGREGATE GEN'L AGGREGATE LIMIT APPLIES PER RODUCTS-COMP/OPS AGG j INCL IN ABOVE X POLICY IPROJECTI LOC TOMOBILE LIABILITY OMBINED SINGLE LIMIT l WNY AUTO Ea acrid tl � LL OWNED AUTOS DOILY INJURY IN^CHEDULED AUTOS (Per person) HIRED AUTOS 'BODILY INJURY -OWNED AUTOS (Peraccident) (NON ROPERTY DAMAGE Per accident) GARAGE LIABILITY kUTO ONLY - EA ACCIDENT ANY AUTO THER THAN - EA ACC GUTO ONLY: AG XCESSLIABILITY -- ACH OCCURENCE - OCCUR (CLAIMS MADE GGREGATE _ EDUCTIBLE RETENTION ORKERS COMPENSATION c sTAT uMITs1 OTHER _ AND EMPLOYERS' LIABILITY I L. EACH ACCIDENT L. DISEASE EA EMPLOYEE .L. DISEASE - POLICY LIMIT OTHER AErrors & Omissions CLS0955782 11/08/2003 11/08/2004 INCLUDED DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS Landscape Gardening and Snow Plowing certificateholder is additional insured. CERTIFICATE HOLD ADDITIONAL INSURED: INSURER LETTER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL City of Fort Collins 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE 215 N. Mason Street 2nd Floor LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY P 0 BOX 580 OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. Fort Collins, CO 80522-0580 AUTHORIZED REPRESENTATIVE C c ACORD 25-S (7/97) Copyright ACORD 9ORPORATION 1988 ACOR>D DATE (MM/DD/YY) TM. CERTIFICATE OF LIABILITY INSURANCE � APR 2204 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION CENTENNIAL INSURANCE GROUP ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 6901 S PIERCE STREET, #220 1 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR LITTLETON CO 80128 PHONE: 720-962-8700 FAX: 720-962-8800 INSURED KORBY LANDSCAPING LLC & KORBY SOD, LLC P.O. BOX 989 6625 N. COUNTY RD. 9 WELLINGTON CO 80549 COVERAGES INSURERS AFFORDING COVERAGE IINSURERA: Pinnacol INSURER B: INSURER C: j INSURER D: INSURER E: NAIC Al 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. POLICYEFFECTNE POLICY INSR TYPE OF INSURANCE POLICY NUMBER EXPIRATION LIMITS LT DATE DATE GENERAL LIABILITY EACH OCCURRENCE $ GENERAL LIABILITY COMMERCIAL E � _ — DAMAGE TO_ RE —. RENTED PISES a oaun:nceL_ -- $ MED. EXP (Any One Person) J CLAIMS MADE OCCUR I $ PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS-COMP/OP AGG $ -- POLICY AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT _ ANY AUTO (Ea accident) $ BODILY INJURY ALL OWNED AUTOS — SCHEDULED AUTOS (Per person) $ BODILY INJURY (Per accident) HIRED AUTOS 1 $ NON -OWNED AUTOS PROPERTY DAMAGE $ GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ ANY AUTO OTHER THAN EAACC I$ AUTO ONLY: ---- --- — ------ AGG $ EXCESS l UMBERELLA LIABILITY EACH OCCURRENCE $ OCCUR �.� CLAIMS MADE AGGREGATE $ I $ DEDUCTIBLE $ $ RETENTION $ WORKERS COMPENSATION AND 4069181 MAY 104 MAY 105 I WC STATU- X TOR_ Y -t6 ._ OTHER EMPLOYERS'LIABILITY _ $ 100,000 f4 E.L. EACH ACCIDENT A ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MeMSER EXCLUDED? E.L. DISEASE -EA EMPLOYEE $ 100,000 R yes, Eewlbs under SPECIAL PROVISIONS below E.L. DISEASE -POLICY LIMIT $ 500,000 (OTHER: DESCRIPTION OF OPERATIONSILOCATION/VEHICLESIEXCLUSIONS ADDED ENDORSEMENT/ SPECIAL PROVISIONS COLORADO !`CGTIVIPATC lJnl nCG I ADDITIONAL INSURED: INSURER LETTER: CAAICPI I AT]nld CITY OF FT. COLLINS PURCHASING PO BOX 580 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, RUT FT. COLLINS, CO 80522-0580 FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. Attention: JOHN STEPHENS AUTHORIZED REPRESENTATIVE ACORD 25 (2001108) Gertificate # 10453 Gary S. uar[er KNIUUU:3LIU3 04/06/2004 16:25 9704610277 FARM BUREAU INSURANC PAGE 02 ACC)EQR CERTIFICATE OF LIABILITY INSURANCE °"�''�"°°' 4 6 a00404 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION JIM MILLER ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 1067 EAGLE DR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. LOVELAND, CO 90537 (970) 461 0278 INSURERS AFFORDING COVERAGE NAICM INSURED KORBY LANDSCAPE, LLC INSURER A: SCOTTSDALE INSURANCE CO INSURER B: PO BOX 989 INSURER O; WELLINGTON, CO 80549 INSURER D: 979 568 7633 INSURER S: 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. PEOFMIMAWPLIMITS POLICY NUMBER EcnvE 11/08/04 A GENERAL LIABILTTY % COMMERCIAL GENERAL LIABILITY CLAIMSMADE DX OCCUR CLS0955782 11/09/03 EACH OCCURRENCE 6 1, 000 OOO PREMISES rcnre S 166,000 MEDEXP(Any on* ppsan) $ 5100.0 PERsoNAL&ADviwvRY s 1,000,000 GENERAL AGGREGATE s 2,000,000 GEWL AGGREGATE LIMIT APPLIES PER: POLICY 2PT LOC PRODUCTS-COMPIOPAGG It INCL ABOVE AUTOMOBILE LIABILITY ANYAUTO ALLOWNEDAUTOS SCHEDULED AUTOS HIRED AUTOS NON OWNEDAUTOS — COMBINED SINGLE LIMIT (Ee 9cxldent) 6 BODILYINJURY (PwP�) S BODILYINJURY (PerstddmQ 6 PROPERTY DAMAGE (Pereckleno : GARAGE LIABILITY ANYAUTO IOTHER AUTO ONLY -EAACCIDENT I THAN EAACC AUTOONLY: AGO 6 6 E%CESSAIMBRELLA LIABILITY OCCUR L—I CLAIMS MADE DEDUCTIBLE RETENTION 1 _ EACH OCCURRENCE 6 AGGREGATE i i 6 S WORKERSCOMPENSATIONANO EMPLOYERS' LIABILITY ANY WKWRETORMARTNEREXEMINO OFFICEPA WMiER EXCUJOE07 YyyBBge deecd6eNMer SPEfi 4 PROVISONS Dhow Ill. EACH ACCIDENT 6 E.L. DISEASE • EA EMPLOYE 6 E.L. DISEASE • POLICY LIMIT I I A OTHER RRORS&OMMISSIONS CLS0955782 11/8/03 11/8/04 INCLUDED OESCRIPTIONOF OPERATIONS I LOCATIONS /VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT/ SPECIAL PROVISIONS LANDSCAPE GARDENING AND SNOW PLOWING *10 DAY NOTICE FOR NON PAYMENT OF PREMIUM City of Ft. Collins 215 N. Mason St 2nd Floor Po box 580 FT. COLLINS, CO 80522-0580 ANCELLAY10N SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATIOI DATE THEREOF. THE OWING INSURER WILL VEKAVOR TO MAILIQ_ DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT. BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABNJTY OF ANY KIND UPON THE INSURER, ITS AGENTS OR ACORD CERTIFICATE OF LIABILITY INSURANCE DATE (MM/ TM. MAY 1903 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION CENTENNIAL INSURANCE GROUP ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 6901 S PIERCE STREET, #220 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR LITTLETON CO 80128 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. PHONE: 720-962-8700 FAX: 720-962-8800 INSURERS AFFORDING COVERAGE NAIC # INSURED INSURER A: Pinnacol KORBY LANDSCAPING LLC & KORBY SOD, LLC INSURER B: P.O. BOX 989 6625 N. COUNTY RD. 9 INSURER C: WELLINGTON CO 80549 INSURER D: I INSURER E: 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. INSR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS LTR DATE (MWDDIYY) DATE (MWDDIYY) GENERAL LIABILITY EACH OCCURRENCE COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTEDPREMISES(Ee occurenca) $ CLAIMS MADE OCCUR MED. EXP (Any One Person) $ PERSONAL B ADV INJURY I$ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OPAGG. $ POLICY ..PROJECT LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT ANY AUTO (Ea accident) $ ALL OWNED AUTOS BODILY INJURY (Per person) $ SCHEDULED AUTOS HIREDAUTOS BODILY INJURY $ NON -OWNED AUTOS (Per accident) PROPERTY DAMAGE $ GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESS I UMBERELLA LIABILITY EACH OCCURRENCE $ OCCUR CLAIMS MADE AGGREGATE $ $ DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATION AND 4069181 MAY 1 03 MAY 104 X WORT ATU- OTHER EMPLOYERS' LIABILITY E.L. EACH ACCIDENT $ 100,000 A ANY PROPRIETORIPARTNERIEXECUTIVE OFFICER/MeMBER EXCLUDED? E.L. DISEASE -EA EMPLOYEE $ 100,000 If yea, describe under IS PROVISIONS below E.L. DISEASE -POLICY LIMIT $ 500,000 OTHER: COLORADO CERTIFICATE HOLDER ADDITIONAL INSURED; INSURER LETTER: CANCELLATION CITY OF FT. COLLINS PURCHASING PO BOX 580 FT. COLLINS, CO 80522-0580 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORETHE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILLENDEAVORTO MAIL30 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, IT'S AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESEWATIVE Attention: ACORD 25 (2001108) Certificate # 4083 RP100061547