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Home My WebLink About380591 J 2 CONTRACTING - INSURANCE CERTIFICATEClient#: 45027 JTWOC ACORD.. CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 12/28/2011 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 Flood &Peterson Ins., Inc. P. O. Box 578 Greeley, CO 80632 970 356-0123 CONTACT NAME: Nancy Keiser PHONE FA Arc No En , 970 356-0123 uc, No): 9705066836 ADDRESS: nancy.keiser@floodand peterson.com CUSTOMER ID e: INSURER(S) AFFORDING COVERAGE NAIC N INSURED INSURER A; Travelers Insurance Company J2 Contracting Company, Inc. PO Box 129 INSURER B: Greeley, CO 80632 INSURER C: 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. L TYPE OF INSURANCEIIWL POLICY NUMBER MWDDNVVY IMMNDONYP LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL UABWTY CI -AIMS -MADE 51OCCUR X PDDed:2,500 DTC0325D65761ND12 1/01/2012 01101/2012 EACH OCCURRENCE S1000000 DAMAGE TO RENTED PREMISES Ea occurrence s300000 MED EXP (Any one person) S5,000 PERSONAL BADVINJURY $1,000,000 GENERALAGGREGATE s2,000,000 GEN'L AGGREGATE POLICY LIMIT APPLIES PER: PRP LOC PRODUCTS - COMP/OP AGG $2,000,000 $ A AU-rOMOBILELIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON OWNED AUTOS 810325D6576TIL12 01/01/2012 01101/2012 COMBINED SINGLE UMIT Be accident) $1.000.000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ 1XX PROPERTY DAMAGE (Per accident)$ $ $ A LIAB EXCESS LIAB OCCUR CLAIMS MADE CUP325D6576TIL12 1/01/2012 _ 01/01/2012 EACH OCCURRENCE $1 000000 dUMBRELLA H AGGREGATE $1 000 000 DEDUCTIBLE RETENTION 10,000 $ X g WORKERS COMPENSATION ANDEMPLOYERS'LIABILrTY YIN ANY PROPRIETORIPARTNERIEXECUTIVEF-1 OFFICERIMEMBER EXCLUDED] (Mandatory In NH) II yes, descdbe under DESCRIPTION OF OPERATIONS below NIA WC STATU OTH- E.L. EACH ACCIDENT Is E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT IS DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Adach ACORD 101, Additional Remarks Schedule, it more space Is required) J2 Contracting J2 Real Estate LLC (See Attached Descriptions) City of Ft Collins 215 North Mason Street 2nd Floor Fort Collins, CO 80522 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 ACORD 25 (2009/09) � 1 Of 2 #S664583/M663474 01988-2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD SLT Client#: 45027 JTWOC ACORDTM CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 12/28/2011 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 Flood & Peterson Ins, Inc. P. O. Box 578 Greeley, CO 80632 970 356-0123 CONTACT NAME: Nancy Keiser PHONE 970 356-0123 FAX A/C No Eg: No A/C , 9705066836 AOGRESS: nancy.keiser@floodand peterson.com CUSTOMER ID N: INSURER(S) AFFORDING COVERAGE NAIC A INSURED J2 Contracting Company, Inc. PO Box 129 INSURER A: Travelers Insurance Company INSURER B: INSURERC: Greeley, CO 80632 INSURER 0: 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, LTIL TYPE OF INSURANCE POLICY NUMBER MWDD/YYY POLICYEXP LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABWTY CLAIMS MADE 51OCCUR X PD Ded:2,500 DTC0325D65761ND12 1/01/2012 01/01/2012 EACH OCCURRENCE $1000000 DAMAGE TO HEWED PREMISES Ea occurrence) s3000OO MED EXP(Any one person) $5,000 PERSONAL &ADV INJURY S7,000,000 GENERALAGGREGATE $2,000,000 GEN'L AGGREGATE POLICY LIMIT APPLIES PER: "I LOC PRODUCTS - COMP/OP AGG 52,000,000 S A AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS 810325D6576TIL12 1/01/2012 01/01/2012 COMBINED SINGLE UMIT (Ea accident) S 1000000 X BODILY INJURY (Per person) S BODILY INJURY (Per accident) $ X X PROPERTY DAMAGE (Per accident) $ $ $ A UMBRELLA LIAR EXCESS LIAB H OCCUR CLAIMS -MADE CUP325D6576TIL12 1/01/201201/01/201 EACH OCCURRENCE $1000000 AGGREGATE $1 00O OOO DEDUCTIBLE RETENTION 10,000 $ X $ WORKERS COMPENSATION AND EMPLOYERS'LIABILITY Y/N ANY PROPRIETORIPARTNERIEXECUTIVE OFFICERIMEMBER EXCLUDED? (Mandatory In NH) II yes, desnibe under DESCRIPTION OF OPERATIONS below WA WCSTATU- OTH- E, L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ EL DISEASE -POLICY LIMIT $ DESCRIPTION OF OPERATIONS / LOCATIONS/ VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more specs Js required) J2 Contracting J2 Real Estate LLC (See Attached Descriptions) City of Fort Collins 215 North Mason Street 2nd Floor Fort Collins, CO 80522 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 #4.*4/1S�-_ ACORD 25 (2009/09) 1 of 2 #S664579/M663474 01988-2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD SILT