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HomeMy WebLinkAbout102136 KORBY LANDSCAPE LLC - INSURANCE CERTIFICATE (3)-Oct 3 2003 12 41PM—Nationwide Insurance No 5521—P 2 A• vhm GcR � �FIGH i t Ur �,IAMILITY INSURANCE OPID CL "hTEI/03/ 08 KORBY-1 10/03 08 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Mountain Plains Agency LLC HOLDER THIS CERTIFICATE DOES NOT AMEND EXTEND OR 4532 McMurry Avenue, Suite 130 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW Fort Collins CO 80525 Phone 970-206-0900 Fax 970-206-0901 INSURERS AFFORDING COVERAGE NAIC0 INSURED INSURER A. Nationwide INSURER B Korb y Landscape 3201 E Mulberry Unit 5 Fort Collins CO 80524 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 SE ISSUED OR MAYPERTAIN THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS EXCLVSIONSANDCONOITIONSOF SUCH POLICIES AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS Duq- LTR NSR 0 TYPE OF INSURANCE POLICY NUMBER POLICY DATE MFFrvuwy EC pD'Y) "no DATE $IM LIMITS GENERAL LIABILITY EACH OCCURRENCE *1000000 X COMMERCIAL GENERAL LIABILITY CLAIMS 1140E OCCUR ACP2603151005 11/10/07 11/10/08 $ FREMISES(EeoecurFlwe 3100000 MED EXP (A(y me pp ) $ 5000 PERSONAL S ADV INJURY $1000000 GENERAL AGGREGATE $2000000 GEN L AGGREOATE LIMITAPPLIES PER POLICY F7 JECT LOC PRODUCTS COMP/OPAGG 92000000 AUTOMOBILE LIABILITY ANYAUTO ACP2603151005 11/10/07 11/10/08 COMBINED SINGLE LIMO IEaacaawl) $1000000 X ALL OWNED AUTOS SCHEDULED AUTO$ BODILY INJURY (Pw PeNw) 3 X HIRED AUTOS NON -OWNED AUTOS BODILY INJURY (Paz eccWenq $ PROPERTY DAMAGE IF& Pccda ) $ GARAGE LIABILITY ENT $ ANY AUTO ACC $ AGG $ EXCESSIUMBRELLA LIABILITY OCCUR CLAIMS MADE jAGORjEGAjTG $ $ b DEDUCTIBLE S RETENTIQN $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY TORY LIMIT$ ER EL EACH ACCIDENT $ ANY PROPRIETOWPARTNEFVEXECUTWE OFFICERA%MBER EXCLUDED? E L DISEASE 6A EMPLOYEE 9 If Yes aeeOMe mlda 3PECIALPROVISIp NSDNoI EL DISEASE POLICY LIMIT 4 OTHER OpCRIPTgN OF OPERATIONS LOCATIONS I VEHNdESI EXCLUSIONS ADDED RY ENDORSEMENT I SPECIAL PROVISIONS Landscape/Maintenance/Lawn Service City Of Fort Collins Purchasing is listed a additional insured rFRTIPIraTF unl nen MXIY4CLLNI IVIY CTYFORT 1 ENOUW ANYOF THE ABODESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE TX F VE THE ISSUING INSURM WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN City Of Fort Collins NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT BUT FAILURE TO DO SO SHALL Purchasing INPOSENOOBLNIATION R LIABILITY OF ANY IDND UPON THE INSURER ITSAGENTSOR PO Box 580 REPRESENTAI VEs Fort Collins CO 80522 AUTHORIZEO RE TAmE t " 2003-12 42PM—Nat onw de Insurance No 5521—P 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 ACORD CERTIFICATE OF LIABILITY TM PRODUCER Ph" IN U ANCE902-87M R UP Syt $BOO CENTENNIAL INSURANCE GROUP LITTL PIERCE STREET1288231 LITTLETON CO 80128 INSURANCE DATE(MMro0/YYYI� 00//012008 ERTIFICATE 19 ISSUED AS A MATTER OF INFORMATION ND CONFERS NO RIGHTS UPON THE CERTIFICATE R THIS CERTIFICATE DOES NOT AMEND EXTEND OR THE COVERAGE AFFORDED BY THEPOLICIESBELOW ORDING COVERAGE #1,11INSURER INSURED KORBY LANDSCAPING LLC 6 KORBY SOD LLC 3201 E MULBERRY STREET UNITS nnecDl JIMAdICS FORTCOLLINS CO 00524 INSURER D INSURER E COVERAQER THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED STANDING TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED NOTWRH ANY REQUIREMENT TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIB CERTIFICATE yV1Y BE ISSUED OR MAY PERTAIN THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALLTHE TERMS EXCLUSIONS AND CONDITIONS OF SUCH POLICIES AGGREGATE LISTS SHOWN MAY HAVE BEEN REDUCED BY PAO CLAIMS No LTR I TYPE OF IN$DRANCE POLICY NUMBER PCNCY EFFECTIVE POLICY BXPIRATKNI uYTn GENERAL LUIBLITY COMMERCIAL GENERAL LIABILITY CLAIMS MADE � OCCUR EACHOCCURRENCE y DAMAOl TD gENDO PRDal6 s MED EXP (Any ons pEraon) (Ally" y PERSONAL B AOV INJURY y GENERAL AGGREGATE $ GEN L AGGREGATE LIMIT APPLIES PER POLICY PRO E T LOC PRODUCTS COMPOP AGG S AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON OWNED AUTOS COMBINED SINGLE LIMIT (Ea am Q f BODILY INJURY (Pa1 PE ) y INJURY (P V BODILYNJURY NJ 11 s PROPERTY DAMAGE Pal soOC y GARAGE LIABXJTY ANY AUTO AUTOONLY EAACCIDENT y OTHER THAN EA ACC AUTO ONLY ADDIS y EXCEBB I UMBRELLA LIABILITY OCCUR CLAIMS MADE — DEDUCTIBLE RETENTION y EACH OCCURRENCE S AGGREGATE y --- - - S -- y y A WORKERS OCMPEN$ATION AND EMPLOYER$ LIABILITY ANYMONBETOIVPAIITNERACIlCUTN! onx:ERAMNMR ucLIREaT RTw yF Hy �y1 PROYOIONa bN w 4069181 05/01108 06/01/09 X roavruNRa OTHER EL EACH ACCIDENT y 100000 EL DISEASE EA EMPLOYEE B 100 000 E L DISEABE POLICY LIMIT 7 $00 000 OTHE OTHER DESCRIPTION OF OPERATIONSILOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/ SPECIAL PROVISIONS COLORADO CERTIFICATE HOLDER .....__..._._.. CITY OF FT COLLINS PURCHASING PO BOX S80 FT COLLINS CO 80522-0580 Attention JOIN STEPHENS (2001108) Certificate SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORETHE EXPIRATION DATE THEREOF THE ISSUING INSURER VALLENDEAVORTO MNL30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT BUTFAILURE TO DO SO SWILL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER FTS AGENTS OR REPRESENTATIVES S Carter IMPORTANT If the certificate holder is an ADDITIONAL INSURED the policy(res) 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 terns 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 Cerdficete 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 %CORD INS025 (otun) on P "T O12