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HomeMy WebLinkAbout113664 JORDAN'S TREE MOVING & MAINTENANCE INC - INSURANCE CERTIFICATEOP ID: SC '4� oRo CERTIFICATE OF LIABILITY INSURANCE F °AT03109°""""' 03/09/11 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. 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 endorsements . - - PRODUCER 970-223-1804 Front Range Insurance Group 1100 Haxton•Drive Suite 100, - CONTACT PHONE FAX Arc,No EX[' ac No :' - Fort Collins, CO 80525 David A. Wooldridge LUTCFAAI EMAIL .. ADDRESS: PRODUCER JORDA-2 C T MERIDN: INSURERS AFFORDING COVERAGE NAIC p INSURED Jordan's Tree INSURER A: The Hartford Moving & Maintenance, Inc. INSURER B: Pinnacol Assurance 41190 1025 Smithfield Drive Fort Collins, CO 80524 INSURER C: INSURER D: INSURER E : 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 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. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE 1 UB POLICY NUMBER EFF MMIDDIYYri MPOLICY MI ICY EXP D INYYY LIMITS A,: GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE 1K OCCUR X 34UUNSR3887 03/10/11 03/10/12 EACH OCCURRENCE $ 1,000,00 P�`REMISES EaaoccurE rrence $ . - 300,00 MED EXP Any one person) $ 10,00 PERSONAL &ADV INJURY $ 1,000,00 GENERAL AGGREGATE ' $ 2,000,00 GEN'L AGGREGATE LIMIT APPLIES PER X POLICY PRO LOC JECT PRO DUCTS -COMPIOP AGG $ 2,000,00 $ A AUTOMOBILE LIABILITY ANYAUTO ALL OWNED AUTOS SCHEDULED AUTOS HIREDAUTOS NON -OWNED AUTOS X 34UUNSR3887 03/10111 03/10/12 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,00 X BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (PeraccidenI) $ X X $ $ UMBRELLA LIAR EXCESS LAB OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DEDUCTIBLE RETENTION $ $ $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITYQR��LIIV ANY PROPRIETOR/PARTNERIEXECUTIVE YIN OFFICERIMEMSER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below,,J NIA 4040726 03/10/11 03/10/12 WC STATU- X OTH- IS ER E.L. EACH ACCIDENT $ 1,000,00 E.L. DISEASE - EA EMPLOYEE $ 1,000,00 E.L. DISEASE - POLICY LIMIT $ 1,000,00 p Equipment Floater 34UUNSR3887 03/10/11 03110112 leased 250,00 Ded 50 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is required) The City of Fort Collins, its officers, agents and employees are named as additional insured with regards to general and auto Liability. CERTIFICATE HOLDER CANCELLATION CITY OF SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Fort Collins THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN PUchasing Dept. ACCORDANCE WITH THE POLICY PROVISIONS. PO Box 580 AUTHORIZED REPRESENTATIVE Fort Collins, CO 80522 ACORD 25 (2009109) ©1988-2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD OP ID: SC CERTIFICATE OF LIABILITY INSURANCE 703/09/11 m THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES - BELOW.' THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the policy(ies) must be endorsed. 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 endorsements . PRODUCER 970-223-1804 Front Range Insurance Group 1100 Haxton Drive Suite 100 Fort Collins, CO 80525 David A. Wooldridge LUTCFAAI CONTACT NAAl PHONE FAX INC. No Eat: INC, No: E-MAIL ADDRESS: PRODUCER JORDA-2 C TOMERIDA: INSURERS AFFORDING COVERAGE NAIC p INSURED Jordan's Tree INSURER A: The Hartford Moving & Maintenance, Inc. INSURER B: Pinnacol Assurance 41190 1025 Smithfield Drive Fort Collins, CO 80524 INSURER C INSURER D: INSURER E : 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 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. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR -. TYPE OF INSURANCE OD B POLICY NUMBER MMDDNYYY) (MMIDDNYYYI LIMITS A GENERAL LIABILITY - X COMMERCIAL GENERACLIABILITY CLAIMS -MADE Fx� OCCUR X 34UUNSR3887 03/10111 03110/12 EACH OCCURRENCE $ 1,000,00 PREMISES Ea occurrence $ 300,00 MED EXP (Any one person) S 10,00 PERSONAL &ADV INJURY $ 1,000,0001 GENERAL AGGREGATE $ 2,000,00 GEN'L AGGREGATE LIMIT APPLIES PER: PRO-LOC X POLICY JECT PRODUCTS - COMPIOPAGG $ 2,000,00 $ A AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIREDAUTOS NON-OWNEDAUTOS - - -" 34UUNSR3887 03/10/11 03/10/12 COMBINED SINGLE LIMIT $ 1,000,00 X BODILY INJURY BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE IPeraccident) $ X X $ UMBRELLA LIAR EXCESS LIAR OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DEDUCTIBLE RETENTION $ $ $ 13 WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETORIPARTNER/EXECUTIVE YIN OFFICERIMEMBER EXCLUDED? (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below NIA 4040726 03110111 03110/12 WCSTATU- X OTH- IMITS E.L. EACH ACCIDENT $ 1,000,00 E.L. DISEASE - EA EMPLOYEE $ 1,000,00 E.L. DISEASE -POLICY LIMIT $ 1,000,00 A Equipment Floater 34UUNSR3887 03110/11 03110112 leased 250,00 Ded 50 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remark. Schedule, 11 more space Is required) the City of Fort Collins is named as an additional insured with regards to general liability CERTIFICATE HOLDER CANCELLATION CITY OF SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Fort Collins THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Forestry Division ACCORDANCE WITH THE POLICY PROVISIONS. PO Box 580 AUTHORIZED REPRESENTATIVE Fort Collins, CO 80522 G. ACORD 25 (2009109) © 1988.2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD