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Home My WebLink AboutMLS AIR CONDITIONING - INSURANCE CERTIFICATE (2)Client#: 47181 MLSAI ACORU, CERTIFICATE OF LIABILITY INSURANCE 11/04/OSDnrrv) PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Flood & Peterson Insurance Inc ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 4821 Wheaton Drive HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. P 0 Box 270370 — Fort Collins, CO 80527 INSURERS AFFORDING COVERAGE NAIC # INSURED MILS; Air Conditioning Inc. 546 8th St S. E. #Bldg. B, Suite 6 Loveland, CO 80537-6455 INSURERA: Auto -Owners Insurance Group INSURER B: Pinnacol Assurance _ INSURER C: INSURER D: INSURER E: COVERAGES 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN 15 SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR NSR TYPE OF INSURANCE POLICY NUM8ER POLICY EFFECTIVE DATE MFFECTIY POLICY EXPIRATION OATS EXPIRATION LIMITS A GENERAL LIABILITY VXCOMMERCIAL GENERALLIABILITV AIMS MADE 51OCCUR 0546327400195408 CANCELLED 04/27/08 10/27/08 EACH OCCURRENCE $1 000 000 DAMAGE TO RENTED $306000 MED EXP (Any one person) $10 000 PERSONAL&ADV INJURY $1000000 GENERAL AGGREGATE s2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO E T OC PRODUCTS - COMP/OP AGG $2000000 A AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON-0WNED AUTOS Drive Other Car 4639984902 CANCELLED 04127/08 10/27/08 COMBINED SINGLE LIMIT (Ea accident) $1,000,000 X BODILY INJURY (Per person) $ X BODILY INJURY (Per accident) $ X X PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY ANY AUTO AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC AUTO ONLY: AGO $ $ A EXCESSAJMBRELLA LIABILITY X I OCCUR CLAIMS MADE DEDUCTIBLE X RETENTION $ 0 4641356700 CANCELLED 04/27/08 10/29/08 EACH OCCURRENCE $1 000 000 AGGREGATE $1,000,000 $ $ B WORKERS COMPENSATION AND EMPLOYERS'LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? If yes, er SPECIAL PROVIScribe IONS below 4104708 10/01/08 10/01/09 X WCSTATU- OTH- E.L. EACH ACCIDENT $1,000,000 E.L. DISEASE - EA EMPLOYEE $1,000000 E.L. DISEASE � POLICY LIMIT $1,000,000 OTHER DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS City of Fort Collins PO 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 DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR ACORD 25 (2001/081 1 of 2 91VI429347 Rxn 0 ACORD CORPORATION 198E 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 25-S (2001/08) 2 of 2 #M429347