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Home My WebLink AboutFORT COLLINS HYDRO SEE ROCKY MOUNTAIN SEEDING - INSURANCE CERTIFICATE'ACORD CERTIFICATE OF LIABILITY INSURANCE OP MM FORTC-1 DATE (MM/DD YYYY) 07/20/09 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Renaissance 101 East Main Insurance Group Street HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Windsor CO 80550 Phone: 970-674-8825 Fax: 970-674-8826 INSURERS AFFORDING COVERAGE INSURER A: Allied Insurance Company NAIC # INSURED INSURER B: Pinnacol Assurance Fort DBA: 1409 Fort Collins Hydro Seed, Inc. Roc kyy Mountain Seeding Sp Cranber Court Collins 0 80524-5421 INSURERC: INSURERD: 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 NSR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE MM/DD/YY POLICY EXPIRATIONLIMITS DATE MMIDD/YY A GENERAL LIABILITY $ COMMERCIAL GENERAL LIABILITY CLAIMS MADE ® OCCUR ACPMCT07551581058 06/07/09 06/07/10 EACH OCCURRENCE $ 1,000,000 r PREMISES (Ea occurence) $ 100 ,000 MED EXP (Any one person) $J , 000 PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE s2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: RO LOC POLICY PC JET PRODUCTS - COMP/OP AGG s2,000,000 A AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS ACPBA7551581058 06/07/09 06/07/10 COMBINED SINGLE LIMIT (Ea accident) $ 1, 000, 000 $ X BODILY INJURY (Per person) BODILY INJURY (Per accident) $ $ PROPERTY DAMAGE (Per accident) GARAGE LIABILITY ANY AUTO N/A AUTO ONLY - EA ACCIDENT $ $ $ OTHER THAN EA ACC AUTO ONLY: AGG A EXCESS/UMBRELLA LIABILITY B OCCUR ❑CLAIMSMADE DEDUCTIBLE X RETENTION $ 10000 ACPCAA7541581058 06/07/09 06/07/10 EACH OCCURRENCE s2,000,000 $2,000,000 AGGREGATE $ $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICERIMEMBER EXCLUDED'? yes, SP SPECIAL PROVISIONS below 2077162 04/01/09 04/01/10 A TORY LIMITS ER E.L. EACH ACCIDENT $1,000,000. E.L. DISEASE EA EMPLOYEE $ 1, 000, 000 E.L. DISEASE -POLICY LIMIT $1 000000 i � OTHER DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION City of Fort Collins -Forestry FAX: 221-6881 Attn: Jim Clark 2145 S. Centre Avenue Fort Collins CO 80526 CITY OF I 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 REPRESENTATIVES. REPRESENTA n ArnDn rnDDnDATlnnl QOQQ 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 (2001/08) NOTEPAD: PA D : INSUIEUI1AME Fort Collins Hydro Seed, Inc. OPIDTCM PAGE 3 DATE 07/20/09 This Certificate of Insurance represents coverage in effect and may or may not be in compliance with any written contract. The following cancellation conditions always apply: - 10 days for non-payment of premium - If policy shown, 10 days for Workers" Compensation for fraud; material misrepresentation, non-payment of premium; other reasons approved by the commissioner of insurance.