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HomeMy WebLinkAbout108979 A & L SERVICES - INSURANCE CERTIFICATECERTIFICATE OF LIABILITY INSURANCE American Family Insurance Company ❑ American Family Mutual Insurance Company it selection box is not checked. 6000 American Ply, Madison, Wisconsin 53763-0001 11161.1 'S Name and Address Anemia Name. Address and Phone Number (Aal./Dist,) Michael Feltz Sr - A & L Services LLC Daniel B Richmond (970) 484-2881 2329 W Mulbefry St 923 E. Prospect Rd Fort Collins, CO 80521-3224 Fort Collins, CO 80525-1110 (006/316) 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 listed below. COVERAGES This Is to oddly that pi of insurance tided bel i halo been issued to Ibo insured named aU W¢ for the policy period indicated, nob'ilhrt,ormng any lequbemenl, tern) or omoddion of any Cori or spur dissonant wilt, respect to ii this ce,li icCle nlay be Issued of may penal, He ins Wanes afforded by the poleiea described herein Is sUbkol 10 all this term¢, e%CIW imo, and o or iliom, of s00t1 peli0ie5. TYPE OF INSURANCE POLICY NUMBER _ POLICYDAT�v__- LIMITS OF LIABILITY EFFECTIVE ExaIRATION' Mo DajVMoDa Yr HOrnee W nerS/ _ _ B ----- lnlury dad Properly Damage Mobilehomeowners Liability Each occurmri $ ,000 Boatowners Liability Bodily Injury and Property Damage „4 Each occuvence $ ,000 Personal Umbrella Liability Bodily lnlury, Arid properly Damage Each Occurence, $ ,000 Farm/Ranch Liability _ Farm LtaUi l Personal LmUilily Erich Occurrence Farm Employer's Liability Enid, OCCUu0nio $ OOO Workers Compensation and Statutory each Accident $ ,000 Employers Liability t Disease Each Employee $ ,000 Disease Polley Limit $ '000 General Liability Cori Aggegme $ 2,000 000 fu-1 Commercial General P(OdUCIa'COmplMed ppelall0115 A4g(CQ81G $ 2,000 ,000 Liability (occurrence) 0 05-XCr�070-03-00 4/28/2008 4/28/2009 Personal and ndVildnen fl;u, $ 1,000 Each Ocourmnco $ 1,0001000 ❑ DamagemPremises Renmd to You $ 100 OOO WdCal Expenso(Any Ono Poison) $ 5 ODO Businessowners Liability each occuvoncot t $ '000 Aggirodett $ '000 Liquor Liability Comma. close Link _ - Aggregate Limit $ ,000 Automobile Liability eory,wfwy Each Person $ 500,000 ❑ Any Auto O All Owned Autos ii lnlury- rash Acbdoot $ 100,000 W Scheduled Autos 05-XC5070-02-00 6/25/2007 6/25/2008 property Damage $ ® Hired Auto 50 ,000 ® Nonowned Autos Bodily Injury and Properly Iximage Combined $ 000 Excess Liability O Commercial Blanket Excess Each Occurrence/Aggregme $ 000 ❑ Other (Miscellaneous Coveraaest OESCHIPTION OF OPERATIONS/LOCATIDNS /VEHICLES/tiESTPoC'ilOeS /SPECIAL ITEM t'rhis individual or panneashown as insomd ❑Have ❑line not The general liability coverage Marl is endorsed to include the City of Fort Collins as adi ilional insured on the elected to be covered as employees under this policy. CG 20 W 07 96 endorsement - stale peal)its t t PoodudsAOmpleled Operations aggregate is equal to east, ottfolai Ilnlit and is included in policy aggrsei CERTIFICATE HOLDERS NAME AND ADDRESS CANCELLATION • City of Ft Collins y TDJ'—Shou any, of U)e above described Policies be cancelled -before the `( Purchasing Division expiration dale thereof, the company will endeavor to mail 30 days) written notice to the Certificate Holder named, but failure to mail such P O Box 580 notice shall impose no obligation or liabilityy of any kind upon the coo any, its agents or representatives, 'TO days different Fort Collins Cc 8D524 unless num�er of days shown. ❑ This certifies coverage on the data of issue only. The above described policies are subject to cancellation in conformity with their terms and by the laws of the state of issue. DATEISSUED AUftIORIZED REPRESENTATIVE n IOrO, /2306 4-2 U-201 Ed. 5/00 Agent Stock No. 06668 Rev. 7102 CERTIFICATE OF LIABILITY INSURANCE American Family Insurance Company ❑ American Family Mutual Insurance Company if selection box is not checked 6000 American Pky Madison Wisconsin 53783 0001 Insureds Name and Address Agent s Name Address and Phone Number (Agt /Dist ) A & L Services LLC Daniel B Richmond (970) 484 2881 2329 W Mulberry St 923 E Prospect Rd Fort Collins CO 80521 3224 Fort Collins CO 80525 1110 (005/316) 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 listed below COVERAGES Th s s to cemfy that poi cas of so ance listed below he a been issued to the Insured named above for the pol cy period indicated notw thstand ng any requirement term or cord Lion of any contract or other dor mart wth aspect to wh ch to s cent f cate may be as ad or may sale n the ins ranee alto ded by the poiic as best bed he ein is subject to all the terns exclusions and coned o s of such policies TYPE OF INSURANCE POLICY NUMBER POLICY DATE LIMITS OF LIABILITY EFFECTIVE EXPIRATION (Mo. Day. Yr Mo De Y Homeowners/ Bodily Inj ry and Property Damage Mobdehomeowners Liability Each Occu a ce $ 000 BOalowners Liability Bodily Injury and Property Damage Each Occu re ce $ 000 Personal Umbrella Liability Bodily In, ry and P clearly Damage Each Occ rrence $ 000 Farm/Ranch Liability Farm Lability & Personal L ab I ty, $ Each Occur ante 000 Fa m Employers Liability Each Occurrence $ 000 Workers Compensation and Statutory , ., ., Each Accident $ 000 Employers Liability t D sease Each Employee $ 000 D sease Policy Limit $ 000 General Liability Ge a at Agg agate 2000 000 _$ Products Completed Operaton$Aggregate $ 20000o0 ® Commercial General U Liability ❑ 05 XC5070 03 00 4/28/2008 4/28/2009 Personal and Ad arising Inu $ 1000 .000Each Occurrence $ 1 000 000 ❑ Damage to Premises Rented to You $ 100 000 Medical Expense (Any One Person) $ 5 0o0 Busmessowners Liability Each Occurrencet t $ 000 Aggragatett $ 000 Liquor Liability Common Cause Lim t $ 000 Aggregate L m t $ 000 Automobile Liability Bodily Injury Each Person $ 50 000 ❑ Any Auto ❑ All Owned Autos Bed ly Injury Each Accident $ 100 000 ® Scheduled Autos 05 XC5070 02 00 6/25/2008 6/25/2009 Property $ ❑ Hired Auto Damage 50 1 ❑ Nonowned Autos ❑ Bad ly Injury and Property Damage Comb retl $ 000 Excess Liability ❑ Commercial Blanket Excess Each 01 ire ce/Aggregate $ 000 ❑ Other (Miscellaneous Coverages) DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I RESTRICTIONS I SPECIAL ITEMS t The Intl dual or partners shown as named ❑ Have ❑ He a not elected to be cc a ad as employees under th s policy t t Products Completed Operators egg agate is equal to each occurrence I m t and Is included in pol cy aggregate CERTIFICATE HOLDER S NAME AND ADDRESS CANCELLATION City of Fort Collins Should any of the above described policies be cancelled before the expiration date thereof the company will endeavor to mall ( 10 days) PO Box 580 written notice to the Certificate Holder named but failure to mail such Fort Collins CO 80522 notice shall impose no obligation or liability of any kind upon the attn Purchasing Dept company its agents or representatives 0 days unless different number of days shown ❑ This certifies coverage on the date of issue only The above described policies are subject to cancellation in conformity with their terms and by the laws of the state of issue DATE ISSUED AUTHORIZE REPRESENTATIVE 9/8/2008 U 201 Ed 5/00 Certificate Holder Stock No 06668 Rev 7/02 CERTIFICATE OF LIABILITY INSURANCE American Family Insurance Company ❑ American Family Mutual Insurance Company if selection box is not checked 6000 American Pky Madison Wisconsin 53783 0001 Insureds Name and Address Agent s Name Address and Phone Number (Agt /Dist ) A & L Services LLC Daniel B Richmond (970) 484 2881 2329 W Mulberry St 923 E Prospect Rd Fort Collins CO 80521 3224 Fort Collins CO 80525 1110 (005/316) 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 listed below COVERAGES Th s s to cemfy that poi cas of so ance listed below he a been issued to the Insured named above for the pol cy period indicated notw thstand ng any requirement term or cord Lion of any contract or other dor mart wth aspect to wh ch to s cent f cate may be as ad or may sale n the ins ranee alto ded by the poiic as best bed he ein is subject to all the terns exclusions and coned o s of such policies TYPE OF INSURANCE POLICY NUMBER POLICY DATE LIMITS OF LIABILITY EFFECTIVE EXPIRATION (Mo. Day. Yr Mo De Y Homeowners/ Bodily Inj ry and Property Damage Mobdehomeowners Liability Each Occu a ce $ 000 BOalowners Liability Bodily Injury and Property Damage Each Occu re ce $ 000 Personal Umbrella Liability Bodily In, ry and P clearly Damage Each Occ rrence $ 000 Farm/Ranch Liability Farm Lability & Personal L ab I ty, $ Each Occur ante 000 Fa m Employers Liability Each Occurrence $ 000 Workers Compensation and Statutory , ., ., Each Accident $ 000 Employers Liability t D sease Each Employee $ 000 D sease Policy Limit $ 000 General Liability Ge a at Agg agate 2000 000 _$ Products Completed Operaton$Aggregate $ 20000o0 ® Commercial General U Liability ❑ 05 XC5070 03 00 4/28/2008 4/28/2009 Personal and Ad arising Inu $ 1000 .000Each Occurrence $ 1 000 000 ❑ Damage to Premises Rented to You $ 100 000 Medical Expense (Any One Person) $ 5 0o0 Busmessowners Liability Each Occurrencet t $ 000 Aggragatett $ 000 Liquor Liability Common Cause Lim t $ 000 Aggregate L m t $ 000 Automobile Liability Bodily Injury Each Person $ 50 000 ❑ Any Auto ❑ All Owned Autos Bed ly Injury Each Accident $ 100 000 ® Scheduled Autos 05 XC5070 02 00 6/25/2008 6/25/2009 Property $ ❑ Hired Auto Damage 50 1 ❑ Nonowned Autos ❑ Bad ly Injury and Property Damage Comb retl $ 000 Excess Liability ❑ Commercial Blanket Excess Each 01 ire ce/Aggregate $ 000 ❑ Other (Miscellaneous Coverages) DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I RESTRICTIONS I SPECIAL ITEMS t The Intl dual or partners shown as named ❑ Have ❑ He a not elected to be cc a ad as employees under th s policy t t Products Completed Operators egg agate is equal to each occurrence I m t and Is included in pol cy aggregate CERTIFICATE HOLDER S NAME AND ADDRESS CANCELLATION City of Fort Collins Should any of the above described policies be cancelled before the expiration date thereof the company will endeavor to mall ( 10 days) PO Box 580 written notice to the Certificate Holder named but failure to mail such Fort Collins CO 80522 notice shall impose no obligation or liability of any kind upon the attn Purchasing Dept company its agents or representatives 0 days unless different number of days shown ❑ This certifies coverage on the date of issue only The above described policies are subject to cancellation in conformity with their terms and by the laws of the state of issue DATE ISSUED AUTHORIZE REPRESENTATIVE 9/8/2008 U 201 Ed 5/00 Certificate Holder Stock No 06668 Rev 7/02 25/092008 13 18 970 484-2945 Susan Clouse Page 22 CERTIFICATE OF LIABILITY INSURANCE American Family Insurance Company ❑ Amencan Family Mutual Insurance Company if selection box is not checked 6000 American Pky Madison Wisconsin 53783 0001 Insured s Name and Address Agent s Name Address and Phone Number (Agl /Dist ) A & L Services LLC 2329 W Mulberry St Fort Collins CO 80521 3224 Daniel B Richmond (970) 484 2881 923 E Prospect Rd Fort Collins CO 80525 1110 (0051316) 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 listed below COVERAGES The a to certify Met pol ass of reu ante I detl below h m he ea d In Me ns red named above for Ina poi cy p od od bated bona thmend ng my reel remenl, tam o mlMd on of my mblred a ohhe do, marl with dap dl wb cb th ccM1fc in may be eeued or may perlam the memmce afforded by the Mnol w desmbed heron a mbjecl to all the tam, atol mom and condhone of a" polices TYPEOFINSURANCE POLICY NUMBER POLICY DATE LIMITS OF LIABILITY FFFEMNE ExPIRATION No. Da Y Moo Yr Homeowners/ Bod lyI Ivy Ad MAY Dam g Mobilehomeowners Liability E Ao m ® $ 000 Boatowners Liability add ly 1Nvy and P opedy Damage Each 0mumence $ 000 Personal Umbrella Liability god lyl Ivy ardP MAY Dam g Each b $ 000 Ferm L abtVTP lb Pa oral Uabhly FarmlRanch Uabllity Baca oce ma ce $ 000 Fam Employers L eh y Each Occurrence $ 000 Workers Compensation and s Who y .ww` E ch Amite t $ 000 Employers Liability t l Ea hEmpl y $ 000 U an Pal yLmI $ 000 General Liability Genera Aggregate $ 2000 000 sum ds Compl lad Ope Mo a Agg egale $ 2000 000 ® Commercial General Pomb ha dM at an I u $ 1 00� Liability (occurrence) 05 XC5070 03 00 4/28/2008 4/28/2009 Each O$ 1 000 000 ¢urtance ❑ ❑ Damage to Ran see Rested to You $ 100 000 M A cal Expense (My One Person) $ 5 000 Buslnessowners Liability EachO ra cett $ 000 Aggragatett $ 000 Liquor Liability Commo CaueaLmt $ 000 Aggregate Um $ 000 Automobile Liability Bod lyI jury Eadr Pe am $ 000 ❑ Any Auto ❑ All Owned Autos Hddlylnlmy Eadh Acodent $ 000 ❑ Scheduled Autos $ ❑ Hired Auto Property Damage 000 NODOWned AUlOn O Bod ly l jury and P boil Damage combated $ 000 Excess Liability ❑ Commercial Blanket Fccess E ch Owu encelAggegate $ 000 Other (Miscellaneous Coverages) DESCRIP11014 OF OPEIRATONSILOCATIONS/ VEHII RESTRICTIMSISPECAM ITEMS tThe 6 dual p H how m marl ❑H a ❑Haw not de M , I ygml The commercial general liability policy is endorsed to include The City of ROcledt.bamFlvaredelea tt operator, aggregate to tl Fort Collins as additional insured on the CIS 20 10 07 04 endorsement o, dote l mt and s nouded m Ml by aggregate CERTIFICATE HOLDER S NAME AND ADDRESS CANCELLATION The Cityof Fort Collins Should any cr the above described policies be cancelled before the =cdon datathereof the company will endeavor to mail ( 30 days) PO Box 580 written net. to the Cerkficate Holder named but failure to mail such Fort Collins CO 80622 noLcppeaa shall impose no obligation or ItablNt�yy of any kind upon the comberyof dayagents geonttsrh or representatives f0 days unless different Attn Purchasing Dept ❑ This call coverage on the date of issue only The above described policies are subject to cancellation in conformity with their terms and by the laws of the state of issue MT UTH IZD REPRESENTATIVE 0 1 cu. U 201 Ed. 5100 Certificate Holder Stack No 06668 Rev 7/02 25/092008 13 18 970 484-2945 Susan Clouse Page 22 CERTIFICATE OF LIABILITY INSURANCE American Family Insurance Company ❑ Amencan Family Mutual Insurance Company if selection box is not checked 6000 American Pky Madison Wisconsin 53783 0001 Insured s Name and Address Agent s Name Address and Phone Number (Agl /Dist ) A & L Services LLC 2329 W Mulberry St Fort Collins CO 80521 3224 Daniel B Richmond (970) 484 2881 923 E Prospect Rd Fort Collins CO 80525 1110 (0051316) 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 listed below COVERAGES The a to certify Met pol ass of reu ante I detl below h m he ea d In Me ns red named above for Ina poi cy p od od bated bona thmend ng my reel remenl, tam o mlMd on of my mblred a ohhe do, marl with dap dl wb cb th ccM1fc in may be eeued or may perlam the memmce afforded by the Mnol w desmbed heron a mbjecl to all the tam, atol mom and condhone of a" polices TYPEOFINSURANCE POLICY NUMBER POLICY DATE LIMITS OF LIABILITY FFFEMNE ExPIRATION No. Da Y Moo Yr Homeowners/ Bod lyI Ivy Ad MAY Dam g Mobilehomeowners Liability E Ao m ® $ 000 Boatowners Liability add ly 1Nvy and P opedy Damage Each 0mumence $ 000 Personal Umbrella Liability god lyl Ivy ardP MAY Dam g Each b $ 000 Ferm L abtVTP lb Pa oral Uabhly FarmlRanch Uabllity Baca oce ma ce $ 000 Fam Employers L eh y Each Occurrence $ 000 Workers Compensation and s Who y .ww` E ch Amite t $ 000 Employers Liability t l Ea hEmpl y $ 000 U an Pal yLmI $ 000 General Liability Genera Aggregate $ 2000 000 sum ds Compl lad Ope Mo a Agg egale $ 2000 000 ® Commercial General Pomb ha dM at an I u $ 1 00� Liability (occurrence) 05 XC5070 03 00 4/28/2008 4/28/2009 Each O$ 1 000 000 ¢urtance ❑ ❑ Damage to Ran see Rested to You $ 100 000 M A cal Expense (My One Person) $ 5 000 Buslnessowners Liability EachO ra cett $ 000 Aggragatett $ 000 Liquor Liability Commo CaueaLmt $ 000 Aggregate Um $ 000 Automobile Liability Bod lyI jury Eadr Pe am $ 000 ❑ Any Auto ❑ All Owned Autos Hddlylnlmy Eadh Acodent $ 000 ❑ Scheduled Autos $ ❑ Hired Auto Property Damage 000 NODOWned AUlOn O Bod ly l jury and P boil Damage combated $ 000 Excess Liability ❑ Commercial Blanket Fccess E ch Owu encelAggegate $ 000 Other (Miscellaneous Coverages) DESCRIP11014 OF OPEIRATONSILOCATIONS/ VEHII RESTRICTIMSISPECAM ITEMS tThe 6 dual p H how m marl ❑H a ❑Haw not de M , I ygml The commercial general liability policy is endorsed to include The City of ROcledt.bamFlvaredelea tt operator, aggregate to tl Fort Collins as additional insured on the CIS 20 10 07 04 endorsement o, dote l mt and s nouded m Ml by aggregate CERTIFICATE HOLDER S NAME AND ADDRESS CANCELLATION The Cityof Fort Collins Should any cr the above described policies be cancelled before the =cdon datathereof the company will endeavor to mail ( 30 days) PO Box 580 written net. to the Cerkficate Holder named but failure to mail such Fort Collins CO 80622 noLcppeaa shall impose no obligation or ItablNt�yy of any kind upon the comberyof dayagents geonttsrh or representatives f0 days unless different Attn Purchasing Dept ❑ This call coverage on the date of issue only The above described policies are subject to cancellation in conformity with their terms and by the laws of the state of issue MT UTH IZD REPRESENTATIVE 0 1 cu. U 201 Ed. 5100 Certificate Holder Stack No 06668 Rev 7/02