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HomeMy WebLinkAboutH H PLUMBING - INSURANCE CERTIFICATEJACORD. CERTIFICATE OF LIABILITY INSURANCE 04/05/2 6' PRODUCER (806)376-6301 FAX (806)376-1449 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Neely, Craig & Walton, LLP ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 1101 South Taylor HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR P. 0. Box 506 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Amarillo, TX 79105 INSURERS AFFORDING COVERAGE NAIC # INSURED Robert Hollabaunh INSURERA: S f DBA: H & H Plumbing & Mechanical P. 0. Box 7392 Amarillo, TX 79114 e -7• 0:W a eco INSURERS: Texas Mutual Insurance 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 OLDUL TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE (MWDnrrA POLICY EXPIRATION DATE (MWDDIYYI LIMITS GENERAL LIABILITY 04CC117395-9 10/13/2005 10/13/2006 EACH OCCURRENCE $ 1, 000, 00 DAMAGE TO RENTED $ 200,00( COMMERCIAL GENERAL LIABILITY CLAIMS MADE OCCUR $ 10.00 MED EXP (Any one person) A X PERSONAL & ADV INJURY $ 1,000,00 GENERAL AGGREGATE $ 1,000,00( GENT AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 1,000,00( POLICY PRO- JECT LOC AUTOMOBILE LIABILITY AUTO (Ea accident) ident) NED ANGLE LIMIT COMBANY c $ ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY (Per Person) $ HIRED AUTOS NON -OWNED AUTOS BODILY INJURY (Per accident) $ PROPERTYDAMAGE (Per accident) $ GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC AUTOONLY: AGG $ $ EXCESS/UMBRELLALIABILITY X OCCUR CLAIMS MADE 01-XS-140794 10/13/2005 10/13/2006 EACH OCCURRENCE $ 1,000,00 AGGREGATE $ 1,000,000 A $ DEDUCTIBLE $ X RETENTION $ 10, 00 $ WORKERS COMPENSATION AND SBP-0001088994 06/04/2006 06/04/2007 X WCSTATU- FR EMPLOYERS' LIABILITY E.L. EACH ACCIDENT $ 500,000 B ANY PROPRIETORIPARTNERIEXECUTIVE OFFICERIMEMBER EXCLUDED? yes, describe under SPECIALPRO PROVISIONS below E.L. DISEASE - EA EMPLOYEE $ 500, 00 E.L. DISEASE - POLICY LIMIT $ COO, 00 A OTHER ommercial Property 04-CC-117395-9 10/13/2005 10/13/2006 220,000 Buildin 9 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS Plumbing and Heating contractor. Certificate holder is named as Additional Insured in regards to the General Liability. 2006JUN16I.m 9-49 City of Fort Collins Fort Collins, CO 8OS22 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR;fR'EEPRREE�SEENNTTATIVES.T1��� 1 AUTHORIZED REPRESENTATIVE <C / I- Alah ; Stephen Walton, CIC/SRB AL;VKU zD IzuuTroal ©ACORD CORPORATION 1988 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. P1l.VRY LO tLuu71ual