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TOP GUN - INSURANCE CERTIFICATE (2)
ACORD CERTIFICATE OF LIABILITY INSURANCk OP D DATE (MMIDDIYY) oPav-1 10/21/04 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Brown & Brown Inc - Ft Collins ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 125 S Howes, Sth Floor HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR P O Box 2226 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Fort Collins CO 80522-2226 Phone:970-482-7747 Fax:970-484-4165 INSURERS AFFORDING COVERAGE SOD GGu67thesssure Washing Inc. Loveland CO 80538 (:U V tKAUk:b INSURER A: mountain States Mutual INSURER B: Plnnacol Assurance INSURER C: INSURER D: 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 LTR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE MMIDD POLICY EXPIRATION DATE MMIDD LIMITS A GENERAL LIABILITY % COMMERCIAL GENERAL LIABILITY CLAIMS MADE ® OCCUR CPP007386404 10/21/04 10/21/05 EACH OCCURRENCE $1,000,000 FIRE DAMAGE (Any one fire) $100,000 MED EXP (Any one person) $ 10,000 PERSONAL &ADV INJURY $1,000,000 GENERAL AGGREGATE $ 2, 000, 000 GEML AGGREGATE LIMIT APPLIES PER: POLICY JET LOC PRODUCTS - COMP/OP AGG s2,000,000 A AUTOMOBILE LIABILITY ANY AUTO ALL OW NED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS BAP007386404 10/21/04 10/21/05 COMBINED SINGLE LIMIT (Ea accident) $1,000,000 X BODILY INJURY (Per person) $ INJURY BODILYaccident) (Perr acddent) $ PROPERTY DAMAGE (Per accident) $ GARAGE LULBILITY ANY AUTO AUTO ONLY- EA ACCIDENT $ EA ACC OTHER THAN AUTO ONLY: AGG $ $ A EXCESS LIABILITY X OCCUR CLAIMSMADE DEDUCTIBLE $ RETENTION $ 10000 UNB007386404 10/21/04 10/21/05 EACH OCCURRENCE $ 2000000 AGGREGATE $2000000 $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY 4031609 07/01/04 07/01/05 X I TORY LIMITS I I ER E.L. EACH ACCIDENT $500000 E.L. DISEASE - EA EMPLOYEE $ 500000 E.L. DISEASE -POLICY LIMIT $ 500000 OTHER -T DESCRIPTION OF OPERATIONSILOCATIONSNEHICLESIEXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS FTCCITY SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL -ID-- DAYS WRITTEN City of Fort Collins NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL Purchasing Department PO Box 580 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR Fort Collins CO 80522 REPRESENTATIVES. AUTHORIZED REPRESENTATIVE ACORD UP. C RD CERTIFICATE OF LIABILITY INSURANCE OP IDPGU-1 D DATE (MMIDD/10/13/0 4 PRODUCER Brown S Brown Inc - Ft Collins THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 125 S Howes, 5th Floor P O Box 2226 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE Fort Collins CO 80522-2226 Phpne:970-482-7747 Fax:970-484-4165 INSURED INSURER A: Mountain States Mutual INSURERR Pinnacol Assurance INSURER C: Top Gun Pressure Washing Inc. 50D W 67th St Loveland CO 80538 INSURERD: - 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. INSR LTR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE MMIDDIYY POLICY EXPIRATION DATE MMIDD LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS MADE a OCCUR CPP007386403 10/21/03 10/21/04 EACH OCCURRENCE $1,000 000 FIRE DAMAGE (Any me fire) $ 100 000 MED EXP (Any one person) $ 10 000 PERSONAL 3 ADV INJURY $ 1,000 000 GENERAL AGGREGATE s2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO LOC JECT PRODUCTS - COMP/OP AGG $2 000,000 A AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULEDAUTOS HIRED AUTOS NON -OWNED AUTOS BAP007386403 10/21/03 10/21/04 COMBINED SINGLE LIMIT (Ea accident) $ 1 , 000 , 000 X BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY ANY AUTO AUTO ONLY - EA ACCIDENT $ OTHERTHAN EA ACC AUTO ONLY: AGG $ $ A EXCESS LIABILITY X OCCUR CLAIMSMADE DEDUCTIBLE X RETENTION $ 10000 UMB007386403 10/21/03 10/21/04 EACH OCCURRENCE $ 2000000 AGGREGATE $ 2000000 S $ $ B WORKERS COMPENSATION AND EMPLOYERS'LIABILITY 4031609 07/01/04 07/01/05 TF X I TORYLIMITS E.L. EACH ACCIDENT $500000 E.L. DISEASE-EAEMPLOYEE $-900000 E.L. DISEASE -POLICY LIMIT s500000 OTHER DESCRIPTION OF OPERATIONSILOCAPONSIVEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS Painting - Exterior (Pressure Washing) RE: Bid#5827 Parking Structures Snow Removal ••• •v Y/91\VGLL/'111V 1\ FTCPURC SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN City OP Fort Collins NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL Purchasing Department 215 N Mason IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR Fort Collins CO 80522 REPRESENTATIVES. AUTHORIZED REPRESENTATIVE r ACORD 0ACARn'rORP0RATInN 1ARR CERTIFICATE OF LIABILITY INSURANCE OPID D DATE (MMVDDAIY) ACORD GU-1 10/21/04 OP PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Brown & Brown Inc - Ft Collins ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 125 S Howes, 5th Floor HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR P O Box 2226 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Fort Collins CO 80522-2226 Phone:970-482-7747 Fax:970-484-4165 INSURERS AFFORDING COVERAGE Top W 67th ssure Washing Inc. SOD St Loveland CO 80538 COVERAGES INSURER A: Mountain States Mutual INSURERS: Pinnacol Assurance INSURER C: INSURER D: 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 LTR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE MMA)O FULIGY ExPiRATION DATE MMIDDM/ LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS MADE FX] OCCUR CPP007386404 10/21/04 10/21/05 EACH OCCURRENCE $1,000,000 FIRE DAMAGE (Any we fire) $100,000 MED EXP (Any one person) $ 10,000 PERSONAL B ADV INJURY $1,000,000 GENERAL AGGREGATE s2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: 1-1 POLICY JJEECT LOC PRODUCTS -COMP/OP AGG $2,000,000 A AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULEDAUTOS HIRED AUTOS NON -OWNED AUTOS BAP007386404 10/21/04 10/21/05 COMBINED SINGLE LIMIT $1,000,000 $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY ANY AUTO AUTO ONLY -EA ACCIDENT $ OTHER THAN EA ACC AUTO ONLY: AGG $ $ A EXCESS LIABILITY % OCCUR CLAIMSMADE DEDUCTIBLE $ RETENTION $ 10000 UNB007386404 10/21/04 10/21/05 EACH OCCURRENCE $ 2000000 AGGREGATE $ 2000000 $ $ B WORKERS COMPENSATION AND EMPLOYERS'LIABILITY 4031609 07/01/04 07/01/05 R I TORY LIMITS I I ER E.L. EACH ACCIDENT $500000 E.L. DISEASE - EA EMPLOYEE $ 500000 E.L. DISEASE -POLICY LIMIT I $ 500000 OTHER DESCRIPTION OF OPERATIONSILOCATIONSIVEHICLESIEXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS Painting - Exterior (Pressure Washing) RE: Sid#5827 Parking Structures Snow Removal CERTIFICATE HOLDER I N I ADDITIONAL INSURED; INSURER LETTER: CANCELLATION FTCPURC SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WALL ENDEAVOR TO MAIL -1-(L- DAYS WRITTEN City of Fort Collins NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL Purchasing Department 215 N Mason IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR Fort Collins CO 80522 REPRESENTATIVES. AUTHORIZED REPRESENTATIVE • ACORD 25-5 (7197) ©ACORDROORPORATION 1988