HomeMy WebLinkAbout196580 L & L LANDSCAPE - INSURANCE CERTIFICATE (13)Client#: 39557
LLLAN
ACORD,. CERTIFICATE OF LIABILITY INSURANCE
DATE(MM/DWYYYY)
4/20/05
PRODUCER
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Flood & Peterson Insurance Inc
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
4821 Wheaton Drive
P O Box 270370
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Fort Collins, CO 80527
INSURERS AFFORDING COVERAGE
NAIC #
INSURED
L & L Landscape, Inc.
LRD, Inc. dba
P O Box 62
INSURERA: United Fire & Cas.
INSURER B: Pinnacol Assurance
INSURER C:
INSURER D:
Windsor, CO 80550
INSURER E:
:OVERAGES
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 IMMIDDfYYI
POLICY EXPIRATION
DATE (MM/DD/YYI
LIMITS
A
GENERAL LIABILITY
X COMMERCIAL GENERAL LIABILITY
CLAIMS MADE O OCCUR
X PD Ded:250
60066660
04/20/05
04/20/06
EACH OCCURRENCE
$1 DOD 000
DAMAGE TO RENTEDPREM15ES (Ea occurrence
$100,000
MED EXP (Any one person)
$5 000
PERSONAL & ADV INJURY
$1 000 000
GENERAL AGGREGATE
s2 00O OOO
GEN'L AGGREGATE LIMIT APPLIES PER:
POLICY PRO-
JECT LOC
PRODUCTS - COMP/OP AGG
$2 000 000
A
AUTOMOBILE
LIABILITY
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON -OWNED AUTOS
60066660
04/20/05
04/20/06
COMBINED SINGLE LIMIT
(Ea accident)
$500,000
BODILY INJURY
(Per person)
$
X
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
ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICERIMEMBER EXCLUDED?
If yes, describe under
SPECIAL PROVISIONS below
4032158
08/01/04
08/01/05
X WC STAT1 OTH-
ER
E.L. EACH ACCIDENT
$100,000
E.L. DISEASE - EA EMPLOYEd
$100,000
E.L. DISEASE -POLICY LIMIT 1
$500,000
OTHER
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS
Certificate holder is named as Additional Insured.
City of Fort Collins
Purchasing Dept.
P O Box 580
Ft Collins , CO 80522
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL - Q 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
ACORD 25 (2001/08) 1 of 2 #S312484/M312477
MAF Q ACORD CORPORATION 1ORR
IMPORTANT
If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement
on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may
require an endorsement. A statement on this certificate does not confer rights to the certificate
holder in lieu of such endorsement(s).
DISCLAIMER
The Certificate of Insurance on the reverse side of this form does not constitute a contract between
the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it
affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon.
AI:UKU Z5s tZUUVUB) 2 of 2 #S312470/M282601