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HomeMy WebLinkAbout165318 CMS MECHANICAL SERVICES INC - INSURANCE CERTIFICATECERTIFICATE OF LIABILITY INSURANCE OP ID JD DATE()O YYY) 05MMfl17/11 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 endorsement(s). PRODUCER .- Brown � Brown Inc 125 S Howes, 5th Floor P O Box 2226 NAME: PHONE A/C, No, E.t: (A/C, No): -A/C aESS: Fort Collins CO 80522-2226 CUoouc STOMER ID p: CMSMI''.-1 Phone:970-482-7747 Fax:970-484-4165 INSURERIS) AFFORDING COVERAGE NAIC# INSURED S ) INSURER A: Westfield Insurance company 24112 CMS Mechanical Services Inc.♦ 609 Technology Circle, buite fk INSURERB: Plnnacol Assurance Company 41190 INSURER C: Windsor CO 80550 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 I TYPE OF INSURANCE AW WVDI POLICY NUMBER POCICYEFF (MMIOO/YYYY) POLICY (MM/ODIYYYY) LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR TRA6047660 I 04/27/11 04/27/12 EACH OCCURRENCE PREMSEESEeoccurrence) $1,000,000 s300000 MED EXP(Any one person) $10,000 PERSONAL B ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 GENL AGGREGATE LIMIT APPLIES PER: PRO- POLICY JEC OC PRODUCTS-COMPIOP AGO $2,000,000 Ben. $1,000,000 A AUTOMOBILE LIABILITY ANY. AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIREDAUTOS NON -OWNED AUTOS TRA6047660 04/27/11 04/27/12 COMBINED SINGLE LIMIT $1,000,000 X BODILY INJURY BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ $ $ p X UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE TRA6047660 04/27/11 04/27/12 EACH OCCURRENCE $2,000,000 AGGREGATE $ 2 , 000 , 000 IHX DEDUCTIBLE RETENTION $ 10000 $ $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETORIPARTNEWEXECUTNE � I OFFICERIMEMBER EXCLUDED? u (Mandatorym NH) It es, describe under DESCRIPTION OF OPERATIONS below N/A 41 5092 $ T w0%s O6/Ol/11 06/Ol/12 X W TAT - T ' TOYLIMITS ER E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $1,000,000 E.L. DISEASE -POLICY LIMIT $1 000,000 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space is required) l I=K nr I6A I C MULUEK GANCELLATIUN City of Fort Collins Purchasing 281 N College Avenue SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE CITYFTS I THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. ©1988.2009 ACORD 25 (2009109) The ACORD name and logo are registered marks of ACORD