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HomeMy WebLinkAbout465758 HMS CONTRACTORS INC - INSURANCE CERTIFICATE18/2009 WED 16:10 FAX 9705869533 LEN Insurance Z 0 0 1 / 0 0 2 CERTIFICATE OF LIABILITY INSURANCE OPID GG DAT[(MM DOr PRODUCER STAIN-1 11 18 09 THIS CERTIFICATE IS UED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE LBN Insurance Agcy-Johnstown HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 4848 Thompson Pkwy, Ste 200 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Johnstown CO 80534 Phone:970-635-9400 Fax:970-635-9401 INSURERS AFFORDING COVERAGE NAICIM INSURED INSURER A: EMC Insurance C anies Herbert M. Stains INSURERS: Pinnacol Assurance 41190 Contractors Inc INSURERC: Argonaut Insurance 19801 3926 JFK Parkway Unit F Fort Collins CO 80525 INSURERD: INSURER E: COVERAGER 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 POUCIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, UIX LTR NB TYPE OF INSURANCE POLICY NUMBCR POLICY tPPE DATE DDlYYYY D MM1D LIMITS OGNERALLIABIUTY A $ EACH OCCURRENCE $1 OOO 000 PREMISES Eaoccurence $ 100000 COMMERCIAL GENERALLIgBILITY 3D85898 03/12/09 03/12/1O A CLAIMS MADE X OCCUR X ISlanket Addl Ins MED EXP (Any one Perim) $10000 PER SO NAL & ADV INJURY 11 000,000 GENERAL AGGREGATE S 2 000 000 GEN'LAGGREGATE APPLIES P PRODUCTS - COMPIOPAGG s2,000,000 PIMOiT POLICY JECT LOC AUTOMOSILF LIABILITY A % ANY AUTO 3E85898 03/12/09 03/12/10 COMBINED SINGLE LIMIT (Ea accident) $ 1, 000, 000 ALL OWNED AUTOS BODILY INJURY (Per person) S SCHEOULED AUTOS HIRED AUTOS BODILY INJURY (Per accident) S NON -OWNED AUTOS PROPERTY DAMAGE : (Per accident) AARAQS LIABILITY AUTO ONLY - EA ACCIDENT S ANY AUTO OTHER THAN EA ACC i AUTO ONLY: AOG 16 EXCGSS I UMBRELLA LIABILITY A X OCCUR CLAIMS MADE 3J85898 03/12/09 EACH OCCURRENCE 03/12/10 AGGREGATE $1, 000 , 000 $1,000 000 DEDUCTIBLE S X RETENTION $10000 S WORKERS C PENSATION i AND GMPLOYERT LIABILITY YIN X TORY LTATIMITS T ER $ ONY FFICER EMBER!PARTNER/EXECUTIVr� 4065051 06/01/09 OFFICERPRIETOR EXCLUDED? C 06/01/10 E.L EACH ACCIDENT 31rOOD,000 (MendatoryInNH) WC47731822275 06/01/09 (t qqe{, describe under 06/01/10 E.L. DISEASE -EA EMPLOYE E 1,000,000 OTHERI PROVISIONS below OTHER E.L DISEASE -POLICY LIMIT S 1 000 000 A Inland Marine 3C85898 03/12/09 03/12/10 Schad Eq $342 249 r Rented E DGSCRIPTKM OF OPERATIONS I LOCATIONS / VEHICLES / GXCLUSIONB ADDGD BY ENDORSEMENT I SPECIAL PROVISIONS $50,000 If required by written contract or written agreement, the certificate holder Is included as additional insured for ongoing operations under general liability. CFRTIFII'_`ATF Nnl PICK City of Fort Collins P.O. Box 580 281 N College Ave t Collins CO 80522-058D ACORD 25 (2009101) SHOULD ANY OF THE ABOVE DESCRi3G0 POLICIES BE CANCELLED BEFORE THE EXPIRATION CITY017 DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL Q_ DAYS WRITTEN NOTICE TO THE CERTIFICATE MOLDER NAMGD TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPR[SSNTATiVES- AUTHORIZED RrPRERENTATIVC ©1988-2009 ACORD 1110 Av;UKU name and logo are registarod marks Of ACORD 8/2009 WED 16:10 FAX 9705869533 LBN Insurance Z002/002 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 This Certificate of Insurance 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(2009101)