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102136 KORBY LANDSCAPE LLC - INSURANCE CERTIFICATE (4)
ACORD DATE (MM/DD/YYYY) W. CERTIFICATE OF LIABILITY INSURANCE 1 05/1212009 PRODUCER Phone: 720-962-8700 Fax: 720-962-8800 CENTENNIAL INSURANCE GROUP THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 6901 S PIERCE STREET, #350 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR LITTLETON CO 80128 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE NAIC # INSURED INSURER A: Pinnacol KORBY LANDSCAPING LLC INSURER B: 3201 E. MULBERRY STREET UNIT S FORT COLLINS CO 80524 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. INSR LTR ADDT INSR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE MMIDD POLICY EXPIRATION DATE MMIDD/YY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ DAMAGE TO RENTED PREMISES (Ea occurence) $ COMMERCIAL GENERAL LIABILITY CLAIMS MADE :J OCCUR MED. EXP (Any one person) $ PERSONAL & ADV INJURY $ - GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG. $ - POLICY JECPROT F7 LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT ANY AUTO (Ea accident) $ BODILY INJURY ALL OWNED AUTOS (Per person) $ SCHEDULED AUTOS BODILY INJURY - '(Per accident) $ - HIRED AUTOS NON -OWNED AUTOS PROPERTY DAMAGE- $ . (Per accident) 'GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC $ ANY AUTO AUTO ONLY: qGG $ EXCESS / UMBRELLA LIABILITY EACH OCCURRENCE is OCCUR ❑ CLAIMS MADE AGGREGATE $ $ DEDUCTIBLE RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY 4069181 05/01/09 05/01/10 WC X TORYTLIM ITS OTHER E.L. EACH ACCIDENT is 100,000 A ANV PROPRIETOR/PARTNER/EXECUTIVE E.L. DISEASE -EA EMPLOYEE $ 100,000 OFFICER M=_MSER EXCLUDED? If yes, describe. under SPECIAL PROVISIONS below E.L. DISEASE -POLICY LIMIT $ 500,000 OTHER: DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/ SPECIAL PROVISIONS *Except 10 days notice of cancellation for non-payment of premium. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE CI Of Fort CollinsFUrChasin City 9 PO -BOX 580 EXPIRATION DATE THEREOF, THE ISSUING- INSURER WILL ENDEAVOR TO MAIL *30 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 Fort Collins, CO 80522-0580 INSURER, ITS AGENTS OR REPRESENTATIVES. Attention: AUTHORIZED REPRESENTATIVE ary S. Carter ACORD 25 (2001/08) Certificate # 31832 © ACORD CORPORATION 1988