HomeMy WebLinkAbout276712 FINE TREE SERVICE - INSURANCE CERTIFICATE (5)JUL. D. LUUD— 3;7tlrim NU. b'J5
. u�, CERTIFICATE OF LIABILITY INSURANCE
r. 1/Z
07io6/i 6
PRODUCER (970M3-0924 FAX (970)267-2231
CoRmnity First Insurance, Inc.
1075 W HDrsetooth Rd, Ste 100
Fort Collins, CO 90526
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
INSURERS AFFORDING COVERAGE
NAIC #
INSURED Fine Tree Servile, Inc.
Joshua Tree Realty, LLC
PO BOX 270494
Fort Collins, CO 80527-0494
INSURERA The Hartford
INSURER& Pinnacol Assurance
INSURER C'
INSURERD:
INSURER E:
I�AIIL+� � ACC
—THE FY7uCIES 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 16 SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH
POLICIES, AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR
TYPE4P Ul8URANOE
POLICY NUMBER
POLICY EFPECTRIB
POLICY EICPIRATION
UM93
A
GENERAL UABILIPf
X COMMERCIAL GENERAL LIABILITY
CLAIMS MADE 7 OCCUR
34UUNSR4541
07/05/2006
07/05/2007
EACH OCCURRENCE
s 11000,00C
DAMAGE TO RENTED
4 190
MEO W (Any 6ne paMfi)
4 S10001
PERSONALaAOVHWURY
4 11000 00
GENERAL AGGREGATE
4 2 000 0
GENL AGGREGATE LIMIT APPLIES PER,
POLICY F1 m LOC
PRODUCTS • COMPIOP AGG
S 21000,00(
A
AUTOMOBILE LIABILITY
X ANYAUTO
ALL OWNEDAUTOS
SCHEDULED AUTOS
�( HIRED AUTOS
X NON4WNEDAUTOS
34UUNSR4541
07/05/2006
07/05/2007
COMBINED SINGLE LIMIT
no
(Goddwl(
4
11000,00
BODILY INJURY
(Par person)
BODILY INJURY
(Peracddent)
4
PROPERTYDAMAGE
(Par Wbftnt)
4
GARAGE UA13IL17Y
ANYAUTD
AUTO ONLY• EA ACCIDENT
S
OTHER THAN EA ACC
AUTO ONLY: AGO
4
F
EICCEIMMSRR.LA LIABILITY
OCCUR CLAWS MADE
DEDUCTIBLE
RETENTION S
EACH OCCURRENCE
$
AGGREGATE
4
4
S
S
B
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY
ANY FROPRIETORIPARTNEREKECUTNE
OFFPICERI EMBEREMLU'DED?
SXECIALP OVISIONS below
4083365
07/01/2006
07/01/2007
X I wCSTATU. OTW
E.L. EACH ACCIDENT
F 1001O
EL.DISEASE -EAEMPLOY
4 1001
E.L. DISEASE• POLICY LIMIT
1 $ 500,00
OTHER
DESCRIPTION OF OPERATIONS! jIONS/%MOCLESI EXCLUSIONS ADDED BY ENDORSEMENT SPECIAL PROVL9KRIS
he City of Fort Co3 ins is listed as additional insured relating to the Insured's ongoing operations
cF:nnPIf-ATF Nel nFw r_ANCG1 I ATInN
City Of Fort Collins
Purchasing Division
John Stephen
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,
215 N Mason
BUT FAILURE TO NAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY
PO BOX 580
OF ANY KIND UPONTN SURER, ITS A Tg RFPRESENTATIVES.
Fort Collins, CO 80522
AUTHORIZED REPRESESATYIE a
Doris G. Car
ACORD 25 (2001/08) FAX: (970)221-6707 O OACORD CORPORATION 1986
UL. 6. 2006- 3:58P^, NO. 695--P, 2/
IMPORTANT
If the certificate holder is an ADDITIONAL INSURED, the policy(es) 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 insurier(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.
ACORD 25 (2001108)