HomeMy WebLinkAboutROCKY RIDGE NURSERY & LANDSCAPE LLC - INSURANCE CERTIFICATEACORDP CERTIFICATE OF LIABILITY INSURANCE
DATE
ON231211YY)
03I23I20„
PRODUCER
INNACTHIS
ASSURANCE
CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY
7501 E o
501 Lowry Blvd
Denver, CO 80230-7006
AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE
COVERAGE AFFORDED BY THE POLICIES BELOW.
INSURERS AFFORDING COVERAGE NAIC#
INSURED
ROCKY RIDGE NURSERY & LANDSCAPE LLC
INSURER PINNACOL ASSURANCE
41190
INSURER B:
327 EAST COUNTY RD 60
INSURERC
FORT COLLINS, CO 80524
INSURER D'.
INSURER E'.
COVERAGES
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDNG
ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMMENT 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
ADDl
POLICY EFFECTIVE
POLICTEXPIPATION
LIE
INSRD
TYPE OF INSURANCE
POLICYNUMBER
DATEIMMIDONYYY)
DATE(MMIDDNYYT)
LIMITS
GENERAL LIABILITY
EACH OCCURRENCE
DAMAGE TO RENTED
COMMERCIAL GENERAL LIABILITY
CMAIMSMADE F1 OCCUR
PREMISES
MED EXPIAny one Person
PERSONAL B ATV INJURY
GEN'L AGGREGATE LIMIT APPLIERS PER:
GENERAL AGGREGATE
PRODUCTS -COMPOSE AGO
POLICY PROJECT LOC
AUTOMOBILE LIABILITY
COMBINED SINGLE LIMIT
ANYAUTO
JE. AccM PIII
BODILY INJURY
ALL OWNED AUTOS
SCHEDULED AUTOS
(Per Person)
BODILY INJURY
HIRED AUTOS
NON OWNED AUTOS
(Peratt "M)
PROPERTY DAMAGE
I Peramidenp
GARAGE LIABILITY
AUTOONLY-EAACCIDENT
OTHER THAN EAACC
ANYAUTO
AUTO ONLY: AG
E%CESSNMBRELLA LIABILITY
EACH OCCURRENCE
'
AGGREGATE
OCCUR CLAIMS MADE
DEDUCTIBLE
RETENTION $
WORKERS COMPENSATION AND
WC STATU- OTHER
A
EMPLOYER'S LIABILITY
ANY PROPRIETOPoPARTNERELUTNE
/E%
4061992
10/01/2010
10/01/2011
TDRv uMITs
EL EACH ACCIDENT
$100,000
OFFICER/MEMBER EXCLUDED'
ELDISEASE-EAEMPL
$100,pp0
I(ye5. pleazedeunpeuMm SPECIAL PROVISIONS IPNw
ELDISFASE- POLICY LIMITIMIT
$pp ppp
OTHER
DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
CERTIFICATE HOLDER
CANCELLATION
1298447
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
CITY OF FORT COLLINS
THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO
P O BOX 580
MAIL 0 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE
FORT COLLINS CO 80522
LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR
LIABILITY OF ANY KIND UPON THE COMPANY, ITS AGENTS OR
REPRESENTATIVES.
AUTHORIZED REPRESENTATIVE
Irma Vigil
ACORD 25)2001I08)
Underwriter ACORD CORPORATION 1988
03/23/2011 10:54:19 AM PINNACOL ASSURANCE PAGE 2 OF 3
ACOR CERTIFICATE OF LIABILITY INSURANCE
DSIn/aU 11
PRODUCER
INNTHIS
ASSURANCE
CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY
501 E Lowry Blvd
7501E o
Denver, CO 80230-7006
AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOTAMEND. EXTEND OR ALTER THE
COVERAGE AFFORDED BY THE POLICIES BELOW.
INSURERS AFFORDING COVERAGE NAIC#
INSURED
ROCKY RIDGE NURSERY 8 LANDSCAPE LLC
INSURER PINNACOL ASSURANCE
41190
INSURER B.
327 EAST COUNTY RD 60
FORT COLLINS, CO 80524
INSURER C
INSUPERD.
INSUPERE.
COVERAGES
THE POLICIES OF INSU RANGE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDNG
ANY REOU IREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMM ENT 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
ACC'L
POLICY EFFECTVE
PamrEXPIRAnOry
LOP
INSPD
LYPEOFINSUPPNCE
POLICYNU.MSER
DArEIMM/DOM/YY1
OATE(MMNO'M)
UMW
OENERALLWBILITY
EACH OCCURRENCE
DAMAGE TO RENTED
COMMERCIAL GENERAL UA9IUTY
CLAMS MADE OCCUR
PREMISES
MED E'R(All ane lf..n)
PEPSg ALS ADV INU RY
C£NL AOOREOATE UMITNPUEPS PER
CENE7AL AGGREGATE
PRODVLTS-LOMPIOP AGO
PDULY PPQ:ECT LOC
AUTOMOBILE LW 8ILITY
COMBINED ANS'YE LIMIT
ANY AUTO
(ES-1C derv)
BODILYINIURY
ALL WMED AUTCS
SOHEOULED ALTOS
(Pa"p "
BODILYINIURY
HIRED AUTOS
NONOWNEDAUTOS
(PETBm'A'N
PROPERry DAMAGE
(PATO..'YD
DARADE LU1311I1
AUTOONLY EAACCOENT
OTHER THAN _A ACC
ANYAUTO
AUTO ONLC AG
EXCES LUMHRELN W BILITY
EACH OCCURRENCE
AGGREGATE
OCCUR CWMSMADE
DI
ETENTION i
WORKERS COMPENSATIONAND
-TO TATLL OTHER
A
EMPLOYER'S LWBILITY
ANY ?ROPRI ETOPRMTNE W EXECUTIVE
4061992
10/012010
10/01/2011
ro.RYUMCC
Far,
ELNAcaTENT
$109,000
OFFICEFMCM9ER E%G LUOEDI
E LOISEASE - EA EMPLOYEE
$100.000
If yt# OleazeoaacCba mbxSPECIAL PROVISIOP16 blow
E LDISEACE-PJ'JLYUMIT
1500000
OTTER
DESCRIPTION OF OPER nONSLOCATIONS HIOLESI XCLUSIONS ADDED BY ENDORSEMENT(SPECIALPROMSIONS
CERTIFICATE HOLDER
CANCELLATION
1298447
SHOULD ANY OF THEABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
CITY OF FORT COLLINS
THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR T
P 0 BOX 530
MAIL 0 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE
FORT COLLINS CO 80522
LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR
LIABILITY OF ANY KIND UPON THE COMPANY, ITS AGENTS OR
REPRESENTATIVES.
AUTHORIZED REPRESENTATIVE
Irma Vigil
ACORD 25(2001108)
Underwriter ACORD CORPORATION 1988
03/23/2011 10:54:19 AM PINNACOL ASSURANCE PAGE 3 OF 3
CERTIFICATE HOLDER COPY
CITY OF FORT COLLINS
P O BOX 580
FORT COLLINS CO 80522
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.
03/23/2011 10:54:19 AM PINNACOL ASSURANCE PAGE 1 OF 3
INNAVL
ASSURANCE
Date 03/23/2011
To: CITY OF FORT COLLINS
Fax Number: 970-221-6707
From CUSTOMER SERVICE 303-361-4000
Phone Number: 303-361-4020
Subject: Document: UW13533533874 Policy #: 4061992
Total Pages: 3
Notes: Please contact us if you did not receive any portion of this transmission.
7501 E. Lowry Blvd.
Denver, CO 80230-7006
Phone:303-361-4000
www.pinnacol.com
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