HomeMy WebLinkAboutCORRESPONDENCE - GENERAL CORRESPONDENCE - INSURANCE (2)ACORD
CERTIFICATE OF LIABILITY INSURANCE OPID B2
DATE (MMIDD/YYYI)
HIGH-13
12 30 05
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
NAIC#
INSURED
INSURERA: MOUNTAIN STATES MUTUAL
High Plains Mechanical Service
Inc.
Attn: Judy Schlemer
2020 Airway Avenue
Ft. Collins CO 80524
INSURERB: PINNACOL ASSURANCE
INSURER C:
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.
1NbK
LTR
WV
NSR
TYPE OF INSURANCE
POLICY NUMBER
POLICYEFFECTIVE
DATE MMIDD
POLICY
DATE MRON
LIMITS
A
GENERAL LIABILITY
X COMMERCIAL GENERAL LIABILITY
CLAIMS MADE ® OCCUR
CPP007999804
12/31/05
12/31/06
EACH OCCURRENCE
$1,000,000
PREMISES (Ea occurence)
$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:
POLICY PRO-
JECT LAC
PRODUCTS-COMP/OP AGG
$2,000,000
A
AUTOMOBILE
LIABILITY
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON -OWNED AUTOS
BAP007999804
12/31/05
12/31/06
COMBINED SINGLE LIMIT
(Ea accident)
$ 1, 000, OOO
X
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
EXCESSIUMBRELLA LIABILITY
X I OCCUR CLAIMSMADE
DEDUCTIBLE
$ RETENTION $10000
UNB007999804
12/31/05
12/31/06
EACH OCCURRENCE
$ 1, 000, 000
AGGREGATE
$ 1, 000, 000
$
$
$
B
WORKERS COMPENSATION AND
ANY PROPRIETOR/PARTNER/EXECUTIVE EMPLOYERILITY
IETORWPARTNER/EXECUTIVE
OFFICERlMEMBER EXCLUDED?
If yes, describe under
SPECIAL PROVISIONS below
4052379
04/01/05
04/01/06
$ TORY LIMITS ER
E.L. EACH ACCIDENT
s500,000
E.L. DISEASE - EA EMPLOYEE
$ 50 0 , 0 0 0
E.L. DISEASE -POLICY LIMIT
$500,000
OTHER
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS
Fax: 224-6134
CERTIFICATE HOLDER CANCELLATION
City of Fort Collins
Attn: John Stevens
Building & Inspect Div
P O Box 580
Fort Collins CO 80522
CITYFTC I SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATIOI
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 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
REPRESENTATIVES.
ACORD 25 f20011081