HomeMy WebLinkAbout414759 SWINGLE LAWN TREE & LANDSCAPE CARE - INSURANCE CERTIFICATE (5)ACORD10 1, CERTIFICATE OF LIABILITY INSURANCE DATEZ200I009
9
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Van Gilder Insurance Corp. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
700 Broadway, Suite 1000 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
Denver CO 80203 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
INSURERS AFFORDING COVERAGE
INSURED wsURERA Travelers IndemnitX Company__, C _
Swingle, Inc.; Swingle Lawn, Tree and INSURERB:Pinnacol Assurance
Landscape Care; Arborworks By Swingle _.. _-- ---- ------------
8585 E. Warren Avenue INsuRER c: _.
Denver CO 80231 INSURER D:
INSURER E:
Ltl619 itt[I301IN
HE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.
OTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
ERTIFICATE 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 TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS
A
GENERAL LIABILITY
6306299L758PHX09
10/1/2009
10/1/2010
EACH OCCURRENCE
Sl_UO, 000 _
X COMMERCIAL GENERAL LIABILITY
FIRE DAMAGE (Any one fire)
S30f 000
]CLAIMS MADE IX I OCCUR
MED EXP(Any one person)
S1Q 000_-
_
PERSONAL&ADV INJURY
$1,000, 000
GENERAL AGGREGATE -
$5100O,an
GENL AGGREGATE LIMIT APPLIES PER:
PRODUCTS - COMPIOP AGG
$2, 000�000
POLICYIX PRO- LOC
A
AUTOMOBILE
LIABILITY
8106299L758TIA09
10/1/2009
10/1/2010
COMBINED SINGLE LIMIT
(Eaaccident)
$1, 000, 000
X
ANY AUTO
ALL OWNED AUTOS
BODILY INJURY
$
SCHEDULED AUTOS
(Per Person)
XI
HIREDAUTOS
BODILY
$
X
NON -OWNED AUTOS
accide t)
(Per accident)
PROPERTY DAMAGE
$
(Per a orient)
- GARAGE LIABILITY
AUTO ONLY - EA ACCIDENT
$
ANY AUTO
EA ACC
OTHER ---
5 ---._... _.
AUUTOTO ONLY qGG
$
A
EXCESS LIABILITYf
CUP6299L758IND09
10/1/2009
10/1/2010
EACH OCCURRENCE
$2 000,.000
XJ OCCUR CLAIMS MADE
AGGREGATE
$2, 000, 000
DEDUCTIBLE
$
iX I RETENTION $LQi000
$
B
WORKERS COMPENSATION AND
_
4033574
10/1/2009
10/1/2010
Xl WC-Jj OTH-
T_QI3Y11MIT$
EMPLOYERS' LIABILITY
I
E.L.EACH ACCIDENT
$500 000
E.L.DISEASE EA EMPLOYEE
$500 000_
E.L. DISEASE -POLICY LIMIT
$500 000
A
OTHER
6306299L758PHX09
10/1/2009
10/l/2010
$1, 000,000 Limit
Herbicide & Pesticide
pplicator Coverage
Claims Made
DESCRIPTION OF OPERATIONSILOCATIONSNEHICLESIEXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
s required by written contract or written agreement, the General Liability includes Blanket Additional Insured
Endorsement. As required by written contract or written agreement, Blanket Waivers of Subrogation apply to the General
Liability and Workers Compensation.
s required by written contract or agreement, the City of Fort Collins is included as Additional Insured.
City of Fort Collins
Purchasing
PO Box 580
Fort Collins CO 80522
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED
3EFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER
TILL MAIL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE
'ERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO
;HALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON
'HE INSURER, ITS AGENTS OR REPRESENTATIVES. *EXCEPT 10 DAYS
IOTICE OF CANCELLATION FOR NON-PAYMENT OF PREMIUM.
AUTHORIZED REPRESENTATIVE A/ dr,
ACORD 25-S (7/97)
n
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.
25-S