HomeMy WebLinkAbout102136 KORBY LANDSCAPE LLC - INSURANCE CERTIFICATE (6)MAY.12.2010 03:13 9702060801 Mountain Plains Agency #7073 P.001 /001
0ERTIFICATE OF LIABILITY INSURANCE OP ID CL DATE`""M'°°"YYYj
OS 12/10
THIS CERTIFICATE 18 ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMENO, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POUCIEs
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S). AUTHORIZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
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).
PRODUCER _
-
NAME:
- -
PHONE
�,uvc.Noy:
Mountain Plains Agency LLC(_
4532 McMurry Avenue, Suite 150
ADDRESS:
Fort Collins CO 8052$
RORSY-1
Phone; 970-206-0800 Fax; 970-206-0801
_PUSTOMERIDAk
INSURERS) AFFORDING COVERAGE NAIC0
' RED
INSURER A: Nationwide
Korby Landscape
_
3201 E. Mulberry Unit 5
INSURERS:
Fort Collins CO 80524
INsuaERc:
INSURER D ..
..
RLSURER E :
.. i .
INSURER F :
.. .._ .._.
COVERAGES CERTIFICATE NUMBER:
REVISION NUMBER:
THIS IS TO CERTIFY THAT 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY HE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRJ990 HEREIN IS SUBJECT TO AL L THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES, LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
LTR TYPE OF INSURANCE INSR WVD POLICYNUMSFA (�(POUOY�)
.'. LaRTS ._..
GENERAI,LIABILITY
$ COMMERCIALGENERALI-VallITY ACP260315100$ ii/io/os ii/i0/io
EACH OCCURRENCE $ 1000000
PREMSES(Ea ) $ 100000
I CLAIMS M DE I� I OCCUR i
MED EXP (Any One peraon) S 5000
X
PERSONAL. dADVINJURY $ 100_0000
..-J -. ..
00000
GENERAL AGGREGAT�AG�.$
GENLAGGREGAT�.LIMITAPPLIESPER:'
PRODUCTS - COMP/O00000
POLICY ECT LOG
,
AUTOMOBILE LIABILITY
COM81NED SINGLE LIMIT
ANY AUTO ACP2603151005 is/10/09 ;uiia/io;
X ALLOWNEDAUTOS
(
$
(Fascddenq 1000000
_
BODILY INJURY (Per perapnj $
SCHEDULED AUTOS $
r$
BODILY INJURY (Per nddenl) $
-
_ HIRED AUTOS
PROPERTY DAMAGE
(Par accident) $
NON -OWNED AUTOS
$
UMBRELLA LIAR OCCUR
EACH OCCURRENCE $
�� LlA9 CLAIMS -MADE EX
AGGREGATE �_
DEDUCTIBLE
... $
RETENTION $ i
$
WORKERS COMPENSATION
U_ O -
AND I,WLOYERV LIABILITY Y / N
: 70RY LIMITS , ER
ANY PROPRIETOR/PARTN ER/EXECUTN
OFFiCER1MEMBER EXCLUDED? N I A
E.L. EACH ACCIDENT $
(Man0etory. ')
H Yet describe Under
E.L.DISEASE - L-A EMPLOYE $
-
SCRIPTION OF OPERATIONS below
-
E.L. DISEASE -"POLICY LIMIT $
i
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (An h ACORD 101, AddlMonal RelnarAe Schedule, If Moro Spate is raquired)
City of Port Collins if listed as insured.
additional
CERTIFICATE HOLDER CANCELLATION
FCRTC - 2 I
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES 09 CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
City of Fart Collins
IM
ACCORDANCE TH THE POLICY PROVISIONS,
Financial Serviced AUTHORIZED REPRESENTATIVE
James B. O'Nill
PO Box 580 Caddy Lopez
ort Collins CO 80522-0581 L
®198&2008 ACORD CORPORA N. I rlg resew
ACORD 25 (2009109) The ACORD name and logo are registered marks of ACORD %