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Home My WebLink AboutSTAFFSCAPES - INSURANCE CERTIFICATE (4)The INA Financial Group, Inc. ` IMA of Colorado, Inc. 1550 17th Street Suite 600 Denver, CO 80202 USA City of Fort Collins PO Box 580 Fort Collins, CO 80522-0000 USA This document was brought to you by CertificatesNow. If you have questions regarding the content of this document, please contact the Producer/Agent listed on the certificate of insurance. cc: The data included in this notice and in the attached document is confidential to ConfirmNet and the party responsible for bringing you this information. Powered ByCertificatesNowT" 9/27ACORN, CERTIFICATE OF LIABILITY INSURANCE &VDD YY) 09/27/OS PRODUCER 1-303-534-4567 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION The INA Financial Group, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE INA of Colorado, Inc. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 1550 17th Street ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Suite 600 Denver, CO 80202 INSURERS AFFORDING COVERAGE INSURED INSURER A: Pinnacol Assurance Staf£Scapes INSURER B: 12000 Pecos St., Suite 300 INSURER C: Westminster, CO 80234 INSURERD: I INCI IRFR F- 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 TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION11a. LIMITS GENERAL LIABILITY EACH OCCURRENCE $ FIRE DAMAGE (Any one fire) $ COMMERCIAL GENERAL LIABILITY CLAIMS MADE E OCCUR MED EXP (Any one person) $ PERSONAL & ACV INJURY $ GENERAL AGGREGATE $ GENT AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ POLICY PRO- LOC AUTOMOBILE LIABILITY ANY AUTO COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) $ ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY (Per accident) $ HIRED AUTOS NON -OWNED AUTOS PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC $ ANY AUTO $ AUTO ONLY: AGG EXCESS LIABILITY EACH OCCURRENCE $ OCCUR CLAIMS MADE AGGREGATE $ $ DEDUCTIBLE $ RETENTION $ A WORKERS COMPENSATION AND 4016179 10/01/05 10/01/06 - LIMX WCSTATU- I OTHEEL EMPLOYERS' LIABILITY E.L. EACH ACCIDENT $ 100, 000 E.L. DISEASE - EA EMPLOYE $ 100, 000 E.L. DISEASE -POLICY LIMIT I $500, 000 OTHER E $ DESCRIPTION OF OPERATIONS/LOCATIONS.NEHICLESIEXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS This Certificate shows that H&H Electric, Inc., 228 S. Link Lane, Fort Collins, CO 80524 is covered under the Workers Compensation Policy issued to StaffScapes. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION City of Fort Collins DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL PO Box 590 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. Fort Collins, CO 80522-0000 AUTHORIZED REPRESENTATIVE D, ,,� USA �s�9r/1 ACORD 25-S (7/971 sDzN m ACORD CORPORATION 1988 3428505 Powered BYCertiticatesNow'N 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.