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HomeMy WebLinkAbout120528 FORT COLLINS TREE CARE - INSURANCE CERTIFICATE (2)ATE -CD-4 CERTIFICATE OF LIABILITY INSURANCE 1 O O5/13/13/2008008/D) PRODUCER (303) 776-5122 FAX (303) 776-5495 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION First MainStreet Insurance ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 512 4th Avenue HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR P.O. Box 847 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Longmont, CO 80502 INSURERS AFFORDING COVERAGE NAIC # INSURED Fort Collins Tree Care, Inc. INSURER A: Hartford Fire Insurance Co 19682 301 East Douglas Road INSURERS Pinnacol Assurance Fort Collins, CO 80524 INSURER C' INSURER D. INSURER E: UL)VtKALitJ 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. ILTR OD' TYPEOF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE MM1ODYYI 03/05/2008 POLICY EXPIRATION DATE (MMIDD[YYI LIMITS GENERAL LIABILITY 34UUNSR3900 03/05/2009 EACH OCCURRENCE $ 1,000,000 A X COMMERCIAL GENERAL LIABILITY CLAIMS MADE a OCCUR DAMAGE S(RENTED $ 300,00RREMISE MED EXP (Any one person) $ 10, 000 PERSONAL &ADV INJURY 1,000,000 GENERAL AGGREGATE $ 2,000,000 GENT AGGREGATE LIMIT APPLIES PER: POLICY T PRO- JECT n LOC PRODUCTS - COMP/OP AGG $ 2,000,000 AUTOMOBILE LIABILITY ANY AUTO 34UUNSR3900 03/05/2008 03/05/2009 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 X BODILY INJURY (Per person) $ A ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS X BODILY INJURY (Per accident) $ X PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ $ AUTO ONLY: AGO EXCESSIUMBRELLA LIABILITY OCCUR CLAIMS MADE EACH OCCURRENCE $ AGGREGATE $ $ DEDUCTIBLE RETENTION $ WORKERS COMPENSATION AND 4068879-CANCEFLED 05/01/2008 05/01/2008 X I MSTATU- DTH- EMPLOYERS' LIABILITY E.L. EACH ACCIDENT ------ $ 100,000 jj ANY PROPRIET'OR/PARTNERlEXE.CUTIVE OFFICER/MEMBER EXCLUDED? If yes, describe under E.L. DISEASE - EA EMPLOYEE --- $ 100,000 E. L. DISEASE -POLICY LIMIT $ 500,000 SPECIAL PROVISIONS below OTHER DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT/ SPECIAL PROVISIONS ity of Fort Collins as Additional Insured as required by written contract per General Liability policy form. City of Fort Collins P 0 Box 580 Fort Collins, CO 80522 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 REPRESENTATIVES. AUTHORIZED REPRESENTATIVE Pat Deaver/MMM AGUKU 25 (2001/08) rHA: ky11J)t[1-u)o) ©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. M+ Unu ao tcuuvuat