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Home My WebLink AboutMLS AIR CONDITIONING - INSURANCE CERTIFICATE (3)ACORD,�. CERTIFICATE OF LIABILITY INSURANCE MIDDIVYVV) 1DATE 2130/ 2/30/OS 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 O Box 270370 Fort Collins, CO 80527 INSURERS AFFORDING COVERAGE NAIC # INSURED MLS Air Conditioning Inc. 546 8th St S.E. #Bldg. B, Suite 6 Loveland, CO 80537-6455 w$URFRA. Auto -Owners Insurance Group INSURERS, 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 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, LTR NSR TYPE TYPE OF INSURANCE POLICY NUMBER DATE MMIOD/YV POLICY EXPIRATION DATE MM/DD/YY LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS MADE 5XI OCCUR 0546327400195408 CANCELLED 04/27/08 10/27/08 EACH OCCURRENCE $1,000,000 DAMAGE TO RENTED PR E F oc udanr. $300000 MED EXP (Any one person) $10 000 PERSONAL & ADV INJURY $1 DD0 0t)t) GENERAL AGGREGATE s2,000,000 GEN'L A(3GREGATE.. LIMIT APPLIES PER POLICY PRO- JECT OC PRODUCTS - COMP/OP AGG s2000000 A AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AU FOS SCHEDULED AUTOS HIRED AUTOS NON-OWNEDAUTOS Drive Other Car 4639984902 CANCELLED 04/27/08 10/27/08 COMBINED SINGLE LIMIT (Ea accident) $1,000,000 X BODILY INJURY (Perperson) $ X BODILY INJURY (Per accident) $ T X PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY ANY AUTO AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC AUTO ONLY: qGG $ $ A EXCESS/UMBRELLA LIABILITY X OCCUR CLAIMS MADE DEDUCTIBLE X RETENTION $ 6 4641356700 CANCELLED 04/27/08 10/29/08 EACH OCCURRENCE $1 006 000 AGGREGATE $1,000,000 $ $ $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBF_REXCLUDED' If yes. describe under SPECIAL PROVISIONS below 4104708 CANCELLED 10/01/08 12/23/08 X . WC STA^ U- OTH E. L EACH ACCIDENT $1,000,000 E,L.DISEASE - EA EMPLOYEE $1,000,000 E.L. DISEASE -POLICY LIMIT $1,000,000 OTHER DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS City of Fort Collins PO Box 580 Fort Collins, CO 80522 LD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL _36_ DAYS WRITTEN E TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL E NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR ACORD 25 (2UU1JUU) 1 of 2 #M433423 BXD 0 ACORD CORPORATION 1988 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 #M433423