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HomeMy WebLinkAbout126682 A & M LANDSCAPE INC - INSURANCE CERTIFICATE (3)ACORD,. CERTIFICATE OF LIABILITY INSURANCE OP ID ss DATE (MM DD YYY)
A&MLA-1 08/25/08
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Six & Geving Insurance Inc #4 ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
Denver Branch HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
225 Union Blvd. #575 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Lakewood CO 80228
Phone- 720-962-0930 Fax:720-962-0942 INSURERS AFFORDING COVERAGE NAIC #
INSURED INSURER A: Plnnacol Assurance 41190
INSURER B:
A & M Landscape Inc.
Allen Winter WSURERc:
749 S. Lemay Ave. PMB 221 INSURER D:
Fort Collins CO 80524
INSURER E:
V V Y ln,'V GJ
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
LTR
AD0
INSR
TYPE OF INSURANCE
POLICY NUMBER
6UCY€FFE0E
DATE(Ni
DATE (MM/DD[YYj
LIMITS
GENERAL LIABILITY
EACH OCCURRENCE
S
COMMERCIAL GENERAL LIABILITY
n
CLAIMS MADE �J OCCUR
AMA
PREMISES (Ea occurence)
$
MED EXP (Any one person)
$
&ADV INJURY
$
_
_PERSONAL
GENERAL AGGREGATE
S
GENT AGGREGATE LIMIT APPLIES PER:
PRODUCTS - COMP/OP AGG
$
POLICY PRO LOC
AUTOMOBILE
LIABILITY
ANY AUTO
LIMIT
(O accident)
$
ALLSINGLE
ALL OWNED AUTOS
SCHEDULED AUTOS
BODILY INJURY
(Per person)
S
HIRED AUTOS
NON -OWNED AUTOS
BODILY INJURY
(Per accident)
S
PROPERTY DAMAGE
(Per accident)
$
GARAGE LIABILITY
AUTO ONLY - EA ACCIDENT
S
ANY AUTO
OTHER THAN EA ACC
S
S
AUTO ONLY: AGG
EXCESS/UMBRELLA LIABILITY
EACH OCCURRENCE
$
OCCUR CLAIMS MADE
AGGREGATE
$
DEDUCTIBLE
S
RETENTION S
$
A
WORKERS COMPENSATION AND
EMPLOYERIETORILITY
ANY PROPRIETOR/
4115033
09/01/08
09/01/09
X TORV LIMITS ER
E.L. EACH ACCIDENT
$500000
Of FICER/MEMOER EXCLUDEDP
EXCLUDED?
I! yes, describe under
E.L. DISEASE - EA EMPLOYEE
_
$ 50 0000
-
E.L. DISEASE POLICY LIMIT
$500000
SPECIALPROVISIONSbelow
OTHER
DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT( SPECIAL PROVISIONS
RE: All Projects/All Locations
CTYFT-1 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN
City of Fort Collins NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
Purchasing Or Risk Mgmt P.O. Box 580 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
Fort Collins CO 80522 REPRESENTATIVES.
O ACORD
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).
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.