HomeMy WebLinkAbout457049 AAA PEST PROS - INSURANCE CERTIFICATE (9)�'� " CERTIFICATE OF LIABILITY INSURANCE
ATE
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THIS CERTIFICATE IS ISSUED AS AMATTER 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: H 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 OD08408 1-415-541-7900
CONTACT
Wells Fargo Insurance Services USA, Inc.
PHONE FAX
AAIC,Na EMI- A/C No:
I
E-MAIL
ADDRESS:
45 Fremont Street
Suite 800
San Francisco, CA 94105
INSURERS AFFORDING COVERAGE
NAIC 0
INSURER A: American Safety Indemnity Company
INSURED
INSURER B :
AAA Pest Pros
James Marrquardt
INSURER C:
INSURER D:
PO Box 20235
INSURER E:
Boulder, CO 80308
INSURER F:
COVERAGES CERTIFICATE NUMBER: 20267804 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
AGDL
SUER
POLICY NUMBER
POLICY EFF
MMIDD
POLICY EXP
MM/DO
LIMITS
A
GENERAL LABILITY
X COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE IT] OCCUR
TPG20063508
03/24/1
03/24/12
EACHOCCURRENCE
E 1,000,000
PREMISES Eaocrv-DAWAGETURENTE15
$ 100,000
MED UP (My one person)
E5,000
PERSONAL S ADV INJURY
E 1,000,000
GENERAL AGGREGATE
E 1,000,000
GENT AGGREGATE
X POLICY
LIMIT APPLIES PER:
PRO- JECTLOG
PRODUCTS - COMP/OPAGG
E 1,000,000
E
AUTOMOBILE
LABILITY
ANY AUTO
ALL OWNED SCHEDULED
AUTOS AUTOS
NON -OWNED
HIRED AUTOS AUTOS
COMBINED SINGLE LIMIT
Ea acddant
Is
BODILY INJURY (Per person)
E
BODILY INJURY (Per accident)
E
PROPERTY DAMAGE
Per amiden
E
E
UMBRELLA INB
EXCESS LAB
OCCUR
CLAIMS -MADE
EACH OCCURRENCE
E
AGGREGATE
E
DIED I I RETENTIONS
E
WORKERS COMPENSATION
ANDEMPLOYERS' LIABILITY YIN
ANY PROPRIETORIPARTNERIEXECUTIVE ❑
0FFICERIM EMBER EXCLUDE01
(Mandatory In NH)
If yea, deacdbe under
DESCRIPTION OF OPERATIONS beloe
NIA
WCSTATU- OTH-
3 ER
E.L. EACH ACCIDENT
E
E. L. DISEASE -EA EMPLOYE
E
E.L. DISEASE -POLICY LIMIT I
E
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101, Additional Remark. Schedule, if mom apace Is mqulmd)
Certificate holder is included as additional insured per blanket policy endorsement.
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
of Fort Collins THE EXPIRATION DATE THEREOF, NOTICE WILL BE DEUVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
Attn: Purchasing Division
P.O. Box 580 AUTHORIZED REPRESENTATIVE
Collina, CO 80522
i USA
W
ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD
gporras
20267804
dnhfe recnaved
COMMERCIAL GENERAL LIABILITY
CG 20 33 07 04
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED - OWNERS, LESSEES OR
CONTRACTORS - AUTOMATIC STATUS WHEN
REQUIRED IN CONSTRUCTION AGREEMENT WITH YOU
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
A. Section II - Who Is An Insured is amended to B. With respect to the insurance afforded to these
.. _ .. includeas an additional insured any person or or-
additionalinsureds, the following additional exclu-
ganization for whom you are performing opera-
lions apply:
lions when you and such person or organization
This insurance does not apply to:
have agreed in writing in a contract or agreement
that such person or organization be added as an
1. "Bodily injury', "property damage" or "personal
additional insured on your policy. Such person or
and advertising injury" arising out of the ren-
organization is an additional insured only with re-
dering of, or the failure to render, any profes-
spect to liability for "bodily injury", "property dam-
sional architectural, engineering or surveying
age" or "personal and advertising injury" caused,
services, including:
in whole or in part, by:
a. The preparing, approving, or failing to
1. Your acts or omissions; or
prepare or approve, maps, shop drawings,
2. The acts or omissions of those acting on your
opinions, reports, surveys, field orders,
behalf;
change orders or drawings and specifica-
lions; or
in the performance of your ongoing operations for
b. Supervisory, inspection, architectural or
the additional insured.
engineering activities.
A person's or organization's status as an addi-
2. "Bodily injury" or "property damage" occurring
tional insured under this endorsement ends when
after:
your operations for that additional insured are
completed.
a. All work, including materials, parts or
equipment furnished in connection with
such work, on the project (other thamser-
vice, maintenance or repairs) to be per-
formed by or on behalf of the additional in-
sureds) at the location of the covered
operations has been completed; or
b. That portion of "your work" out of which the
injury or damage arises has been put to its
intended use by any person or organization
other than another contractor or subcon-
tractor engaged in performing operations
for a principal as a part of the same project.
CG 20 33 07 04
0 ISO Properties, Inc.; 2004
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