HomeMy WebLinkAbout124948 TOP GUN PRESSURE WASHING INC - INSURANCE CERTIFICATE (12)ACORv CERTIFICATE OF LIABILITY INSURANCE OP ID D DATE (MMIDDIYY)
PGU-1 06/02/05
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Brown 6 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
INSURED INSURER A: Mountain States Mutual
INSURERS: Pinnacol Assurance
To Gun Pressure Washing Inc. INSURERC:
50�1 W 67th St INSURERD:
Loveland CO 80538
16011/ :11:7_TH *:
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
TYPE OF INSURANCE
POLICY NUMBER
DATE MMIODNY
DATE MMIDDIYY
LIMITS
A
GENERAL LIABILITY
X. COMMERCIAL GENERAL LIABILITY
CLAIMS MADE " OCCUR
CPP007386404
10/21/04
10/21/05
EACH OCCURRENCE
$ 1 , 000 , 000
FIRE DAMAGE (Anyone fire)
$100,000
MED EXP (Any one person)
$ 10 , 000
PERSONAL & ADV INJURY
$ 1 , 000 , 000
GENERAL AGGREGATE
s2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
POLICY PRO -LOG
JECT
PRODUCTS - COMP/OP AGG
s2,000,000
A
AUTOMOBILE
LIABILITY
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON -OWNED AUTOS
BAP007386404
10/21/04
10/21/05
(EaCOMBINED SINGLE LIMIT
CO accident)
$ 1 000 000
r r
X
BODILY INJURY
(Per person)
$
BODILY INJURY
(Per accident)
$
PROPERTY DAMAGE
(Per accident)
$
GARAGE LIABILITY
ANY AUTO
AUTO ONLY - EA ACCIDENT
$
EA ACC
OTHER THAN
AUTO ONLY: AGG
$
$
A
EXCESS LIABILITY
X OCCUR �CLAIMSMADE
IDEDUCTIBLE
x RETENTION $ 10000
UMB007386404
10/21/04
10/21/05
EACH OCCURRENCE
s2,000,000
AGGREGATE
$2,000,000
$
B
WORKERS COMPENSATION AND
EMPLOYERS'LIABILITY
4031609
07/01/05
07/01/06
X-
TORY LIMITS ER
E.L. EACH ACCIDENT
$500000
E.L. DISEASE - EA EMPLOYE
$500000
E.L. DISEASE -POLICY LIMIT
s500000
A
OTHER
Equipment Floater
Leased/Rented
CPP007386404
10/21/04
10/21/05:
Leased/Re $100000
DESCRIPTION OF OPERATIONSILOCATIONSIVEHICLESIEXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
Painting - Exterior (Pressure Washing) RE: Bid#5827 Parking Structures Snow
Removal
,FTCPURC SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATIO
DATE THEREOF, THE ISSUING INSURER MILL ENDEAVOR TO MAIL .1 0 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.
At1�MQ[�iR\ED RE�PRESE
ACORD 25-S (7/97) d#kORD CORPORATION 119RR