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Home My WebLink About102136 KORBY LANDSCAPE LLC - INSURANCE CERTIFICATE (8)ACORI CERTIFICATE OF LIABILITY INSURANCE DATE(MWDDNYYY) 10/20/2011 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 ALESSANDRA INSURANCE AGENCY 3100 S Parker Rd #100 CONTACT NAME: aCo oE(303)745-0404FAX acNe:(303)745-0544 -AL ADDREss ralessandra@f armersagent . com Aurora, CO 80014 INSURER(S) AFFORDING COVERAGE NAICY INSURER A: TRUCK INSURANCE EXCHANGE INSURED INSURER B: Farmers Insurance Group Korby Landscape LLC INSURER C: 3201 E Mulberry St unit F INSURER D: INSURERE: Fort Collins, CO 80524 INSURER F: 970 568 7633 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 LTA TYPE OF INSURANCE ADDL INSR SUER We POLICY NUMBER POLICY EFF MMrDD POLICY MM/DD/Y1'YY LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE CI OCCUR Y 604863001 11/10/11 11/10/12 EACH OCCURRENCE $ 1, 000, 000 PREMISES Ea occurrence $ 100, 000 MED EXP(Any one person) $ 51 000 PERSONAL B ADV INJURY $ 1,000,000 GENERAL AGGREGATE S 2, 000, 000 GEVL AGGREGATE LIMIT APPLIES PER: X POLICY PRO LOC PRODUCTS - COMP/OP AGG $ 2, 000, 000 $ A AUTOMOBILE LIABILITY ANYAUTO ALL OWNED X Aur SCHEDULED Auros ,OWNED WNED HIRED AUTOS AUTOS Y 604863001 11/10/11 11/10/12 Ea accident $ 1, 000, 000 BODILY INJURY (Per person) $ X BODILY INJURY (Per accident) $ Per accident) $ $ A X UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE 604863444 11/10/11 11/10/12 EACH OCCURRENCE s 1,000,000 AGGREGATE $ 1,000,000 DEC) I X I RETENTION$ 10,000 Is B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOWPARTNEWE%ECUnVE YIN OFFICEWMEMBER EXCLUDED? (Marki in INN) If yes, all in under DE SCRIPTION OF OPERATIONS below NIA A04171131 02/23/11 02/23/12 WCSTATU- OTH- TORY LIMITS ER E.L. EACH ACCIDENT $ lOO,000 E.L. DISEASE - EA EMPLOYE $ 100,000 E.L. DISEASE -POLICY LIMIT I $ 500,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) CITY OF FT COLLINS PURCHASING IS LISTED AS ADDITIONAL INSURED ON THE ABOVE REFERENCED GENERAL LIABILITY POLICY CITY OF FT COLLINS PERCHASING DEVISION PO BOX 580 FT COLLINS CO 80522-0580 ATTENTION JOHN STEPHEN FAX:970-221-6707 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. ACORD 25 (2010/05) 01988-2010 ACORD Fhe ACORD name and logo are registered marks of ACORD reserved.