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HomeMy WebLinkAbout126682 A & M LANDSCAPE INC - INSURANCE CERTIFICATE (7)OP ID: JL
'AI �R� CERTIFICATE OF LIABILITY INSURANCE
DATE /11
oan an 1
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 720-962-0930
Six & Gevin Insurance Inc #4
9 720-962-0942
Denver Branch
225 Union Blvd. #575
Lakewood, CO 80228
NAMEACT Olivia Blair
PHONE r"c 720-962-0942
JAlc No, Es ).303-653-0026 ac No).
E-MAIL six- evin
ADDRESS: oblair @ 9 g•com
PRODUCER A&MLA-1
CUSTOMER o k:
INSURER(S) AFFORDING COVERAGE
NAIC p
INSURED A & M Landscape Concepts, Inc.
Allen Winter
749 S. Lemay Avenue, PMB 221
Fort Collins, CO 80524
INSURER A:PinnacolAssurance
41190
INSURER B:
INsuRERc:
INSURER D :
INSURER E
INSURER F :
rc DTrclr ATE NIIMBER: REVISION NUMBER:
V 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 I TYPE OF INSURANCE IIN;R POLICY NUMBER MM OI DY/YYYY MM/DDYIYYYY LIMITS
TR WVD
GENERALUABWTY
EACH OCCURRENCE
$
COMMERCIAL GENERAL UABILIP(
-DAMAGE'TO
PREMISES Ea occurrence)$
MED EXP (Any one person)
$
CLAIMS -MADE OCCUR
PERSONAL & ADV INJURY
$
GENERAL AGGREGATE
S
GEN'L AGGREGATE LIMIT APPLIES PER:
PRODUCTS - COMP/OP AGG
$
$
POLICY n PRO- n LOC
-
AUTOMOBILE
LIABILITY
COMBINED SINGLE LIMIT
(Ea accident)
$
BODILY I NJURY(Per person)
$
ANY AUTO
BODILY INJURY (Per accident)
$
ALL OWNED AUTOS
PROPERTY DAMAGE
(Per accident)
$
SCHEDULEDAUTOS
HIRED AUTOS
$
NON -OWNED AUTOS
$
UMBRELLA LIAB
OCCUR
EACH OCCURRENCE
$
AGGREGATE
$
EXCESS LIAB
CLAIMS -MADE
DEDUCTIBLE
$
$
RETENTION $
A
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY
ANYPROPRIETORIPARTNERIEXECUTIVE YIN
MFand tar, in NHR EXCLUDED?
N / A
4115033
09I01/11
09/01112
X WCSTATU- X OTH-
RV IMIT ER
E.L. EACH ACCIDENT
$ 500,00
E.L. DISEASE - EA EMPLOYE
$ 500,000
E.L. DISEASE -POLICY LIMIT
1 $ 500,00
If yes, describe and r
DESCRIPTION OF OPERATIONS below
DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space Is required)
RE: Weed Mowing & Abatement
r ERTIF!CATE H01 nFR CANCELLATION
CTYFT-4
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
City of Fort Collins
Y
ACCORDANCE WITH THE POLICY PROVISIONS.
Purchasing & Risk Management
PO BOX 580
Fort Collins, CO 80522
AUTHORIZED REPRESENTATIVE
@ 1988.2009 ACORD CORPORATION. All rights reserved.
ACORD 25 (2009109) The ACORD name and logo are registered marks of ACORD
OP ID: JL
,d►�oizo CERTIFICATE OF LIABILITY INSURANCE
DAT08/1 OIYYVY)
OS/18/11
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 720-962-0930
Six 8< Gevin Insurance Incf%4
9 720-962-0942
NAMEACT Olivia Blair
PHONE 303-653-0026 FArc No : 720-962-0942
MC, No Ezt :
Denver Branch
225 Union Blvd. #575 -
Lakewood, CO 80228
E-MAIL oblair SX- eVln
ADDRESS: g g'GOm
IPRODUCER
CUSTOMER ID #. A&MLA-1
INSURER(S) AFFORDING COVERAGE
NAIC It
INSURED A 6 M Landscape Concepts, Inc.
INSURER A; Pinnacol Assurance
49190
INSURER B:
Allen Winter
749 S. Lemay Avenue, PMB 221
Fort Collins, CO 80524
INSURER C
INSURER D
INSURER E
INSURER F
oCAVE Aulsaeoo. HCVISium NUMBER:
I Wv= MVCJ v a ter.• .-.-.....�.-.
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.
ILTR
TYPE OF INSURANCE
DDL
POLICY NUMBER
POLICY EFF
MMIDDIYYYY
POLICY EXP
MMIDD/YYYY
LIMITS
GENERAL LIABILITY
EACH OCCURRENCE
$
_ffA_M_A=_R;N_TED
PREMISES Ea occurrence
IS
COMMERCIAL GENERAL LIABILITY
MED EXP (Any one person)
$
CLAIMS -MADE El OCCUR
PERSONAL It ADV INJURY
$
GENERALAGGREGATE
$
GEN'L AGGREGATE LIMIT APPLIES PER:
PRODUCTS - COMPIOP AGG
$
$
POLICY n PRO LOG
AUTOMOBILE
LIABILITY
COMBINED SINGLE LIMIT
(Ea accident)
$
BOD I LY I NJURY(Per person)
$
ANY AUTO
-
BODILY INJURY(Peraccident)
$
ALL OWNED AUTOS
PROPERTYDAMAGE
(Per accident)
$
SCHEDULEDAUTOS
HIRED AUTOS
S
NON -OWNED AUTOS
UMBRELLA LIAB
OCCUR
EACH OCCURRENCE
$
AGGREGATE
$
EXCESS LIAR
CLAIMS -MADE
DEDUCTIBLE
$
$
RETENTION $
WORKERS COMPENSATION
X WC STATU- X OTH-
LIMITS ER
A
ANDEMPLOYERS'LIABIUTY
ANY PROPRIETORIPARTNEPJEXECUTIVE Y/❑YN
OFFICERIMEMBER EXCLUDED?
(Mandatory in NH)
N/A
4115033
09/01111
09I01112
EL, EACH ACCIDENT
EACH
$ SOQ,000
E.L. DISEASE - EA EMPLOYE
$ 500,000
EL.DISEASE - POLICY LIMIT
$ 500,000
If yes, describe under
DESCRIPTION OF OPERATIONS below
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required)
RE: All Projects/All Locations
r CmTrrinA= uni MED CANCELLATION
CTYFT-1
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
City of Fort Collins
ACCORDANCE WITH THE POLICY PROVISIONS.
Purchasing or Risk Mgmt
P.O. BOX 580
AUTHORIZED REPRESENTATIVE
Fort Collins, CO 80522
y7
© 1988-2009 ACORD CUKPUKA I IUN. AII rights reserved.
ACORD 25 (2009109) The ACORD name and logo are registered marks of ACORD
OP ID: JIL
CERTIFICATE OF LIABILITY INSURANCE
DAT0811811 /11
0811
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 720-962-0930
Six & GevingInsurance Inc tt4 720-962-0942
NAMEpCT Olivia Blair
AI N E,�,303-653-0026 FAX,
AI Ne,720-962-0942
Denver Branch
225 Union Blvd. #575
Lakewood, CO 80228
E1MAIL oblair@six-geving.com
AOORESS:
PRODUCER A&MLA-1
CUSTOMER ID N:
INSURER(S) AFFORDING COVERAGE
NAIC If
INSURED A & M Landscape Concepts, Inc.
INSURER A:Pinnacol Assurance
41190
INSURER B:
Allen Winter
749 S. Lamely Avenue, PMB 221
Fort Collins, CO 80524
INSURER C:
INSURER 0
INSURER E
INSURER F :
COTICli"AYC IdllAan CD- KYVIJIVR 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.
bbL POLICY EFF POLICY EXP
I�TR TYPE OF INSURANCE POLICY NUMBER MMIDDIYYYY MM/DDIYYYY LIMITS
GENERAL LIABILITY
COMMERCIAL GENERAL LIABILITY
EACH OCCURRENCE
$
MAGETURE
PREMISES Ea occurrence
$
MED EXP(Any one person)
$
CLAIMS -MADE F-IOCCUR
PERSONAL B ADV INJURY
$
GENERAL AGGREGATE
$
GEN-L AGGREGATE LIMIT APPLIES PER:
PRODUCTS - COMP/OP AGG
$
$
PRO LOC
POLICY
AUTOMOBILE
LIABILITY
COMBINED SINGLE LIMIT
(Ea accident)
$
BODILY INJURY (Per person)
S
ANY AUTO
BODILY INJURY (Per accident)
$
ALL OWNED AUTOS
PROPERTY DAMAGE
(Per accident)
$
SCHEDULED AUTOS
HIRED AUTOS
8
NON -OWNED AUTOS
UMBRELLA LIAR
OCCUR
EACH OCCURRENCE
$
AGGREGATE
$
EXCESS LIAB
CLAIMS -MADE
DEDUCTIBLE
$
$
RETENTION $
A
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY
ANY PROPRIETORIPARTNEWEXECUTIVE YIN
OFFICERIMEMBER EXCLUDED?
(Mandatory in NH)
If yes, descdbe under
DESCRIPTION OF OPERATIONS below
NIA
4115033
09(01N1
09/01112
STATU-_
X WRV IMIT X OTR
E.L. EACH ACCIDENT
$ 500,00
E.L. DISEASE - EA EMPLOYE
$ SOO,000
E.L. DISEASE -POLICY LIMIT
$ 500,000
DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required)
RE: Spring Canyon Playground Overflow Parking
City of Fort Collins
Purchasing
PO Box 580
215 North Mason
Fort Collins, CO 80524
CTYFT-3
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE
V Ty80-LUUy fiV VRU LV Rr VRM11VIY. NII IIIjNU I<JQrrCu.
ACORD 25 (2009109) The ACORD name and logo are registered marks of ACORD