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HomeMy WebLinkAbout113664 JORDAN'S TREE MOVING & MAINTENANCE INC - INSURANCE CERTIFICATE (2)OP ID: SC '4l R�6 CERTIFICATE OF LIABILITY INSURANCE OAT03/07DYYYY) 03I07/12 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.liuch endorsements . -, - -- -- •- - PRODUCER -- -_ 970-223-1804 - Front Range Insurance Group 1100HaxtonDnveSuite 100 Fort Collins, CO 80525 David A. Wooldridge LUTCFAAI CONTACT NAME: .. ... . _ .. . _. PHONE FAX •- aC NO Ent: AIC E-MAIL ADDRESS, PRODUCER CUSTOMER ID #: JORDA-2 INSURERS) AFFORDING COVERAGE NAIL # INSURED Jordan's Tree INSURER A: The Hartford 30104 Moving & Maintenance, Inc INSURER B:PinnacolAssurance 41190 1025 Smithfield Drive Fort Collins, CO 80524 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. INSR TR TYPE OF INSURANCE POLICY NUMBER MM/DD/YYYV MMIDDYIYYYY EXP LIMITS A ` GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE FX7 OCCUR X 34UUNSR3887 ... ._. . -....: - 03110112 - -- ... 03/10113 .. EACH OCCURRENCE $ 1,000,00 OAMA PREMISEST Ea ocwrrence $ 300,00 -MED EXP (Any one person) $ 10,00 PERSONAL&ADV INJURY $ 1,000,00 GENERAL AGGREGATE $ 2,000,00 SENT AGGREGATE X POLICY LIMIT APPLIES PER - PRO- F7 LOC PRODUCTS - COMPIOP AGG $ 2,000,00 $ A� AUTOMOBILE LIABILITY"" ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS ., 34UUNSR3887 03/10/12 - 03/10/13 COMBINED SINGLE LIMIT (EaaccidenU _ $ 1,000,00 X BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ X X $ $ UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DEDUCTIBLE RETENTION $ $ $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITYDRY ANY PROPRIETOR/PARTNERIEXECUTIVE YIN OFFICER/MEMBER EXCLUDED? ❑ (Mandatory In NH) If yyee, describe under DESCRIPTION OF OPERATIONS below NIA 4040726 03/10/12 03/10/13 X WC STATU- I OTH- LIM E.L. EACH ACCIDENT $ 1,000'00 EL DISEASE - EA EMPLOYEE $ 1,000,00 E. L. DISEASE -POLICY LIMIT $ 1,000,00 A Equipment Floater 34UUNSR3887 03/10/12 03110/13 Leased 250,00 Ded 50 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is required) Holder is listed as Additional Insured with regards to General Liability. Project: Mason Corridor Tree Transplanting CERTIFICATE HOLDER CANCELLATION CITY OF SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Fort Collins tY THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 215 N. Mason Street, 3rd FL Fort Collins, CO 80522-0580 AUTHORIZED REPRESENTATIVE I, ACORD 25 (2009109) © 1988-2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD OP ID: SC ,a►lls o CERTIFICATE OF LIABILITY INSURANCE DAT03107 D/YYYY) 3/07112 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 endorsements . PRODUCER - 970-223-1804 Front Range Insurance Group 1100 Haxton Drive Suite 100 CONTACT NAME: PHONE FAX aC No Eat: IXC,No: Fort Collins, CO 80525 David A. Wooldridge LUTCFAAI EMAIL PRODUCER CUSTOMER IDe.JORDA-2 INSURERS AFFORDING COVERAGE NAIL If INSURED Jordan's Tree INSURER A: The Hartford 30104 Moving & Maintenance, Inc 1025 Smithfield Drive INSURER B: Pinnacol Assurance 41190 Fort Collins, CO 80524 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. INSR LTR ryPE OF INSURANCE A POLICY NUMBER MMI POLICY MMI ODNYYY LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE FRI OCCUR .•• X 34UUNSR3887 03110/12 03/10/13 EACH OCCURRENCE $ 1,000,08 PREMISES Ea occurrence) $ 300,00 MED EXP (Any one person) $ 10,00 PERSONAL B ADV INJURY $ 1,000,00 GENERAL AGGREGATE $ 2,000,00 GENT AGGREGATE LIMIT APPLIES PER X POLICY 0 PRO- LOC PRODUCTS - COMP/OP AGG $ 2,000,00 - - $ A AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON-OWNEDAUTOS X 34UUNSR3887 03/10/12 03110113 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,00 X BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ X X $ UMBRELLA LIAR EXCESS LIAR OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DEDUCTIBLE $ $ F-IRETENTION $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNEFUEXECUTIVE ❑ OFFICER/MEMBER EXCLUDED? (Mandatory In NH) If yes describe under DESC RIPTION OF OPERATIONS below N / A 4040726 03110112 03/10/13 X WC STATU- OTH- E.L. EACH ACCIDENT $ 1,000,00 E.L. DISEASE - EA EMPLOYEE $ 1,000,00 E. L. DISEASE -POLICY LIMIT $ 1,000,00 A Equipment Floater 34UUNSR3887 03/10/12' 03/10/13 Leased 250,00 Ded 50 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ANach ACORD 101, Additional Remarks Schedule, If mom space Is required) The City of Fort Collins, its officers, agents and employees are named as additional insured with regards to general and auto Liability. CERTIFICATE HOLDER CANCELLATION CITY OF SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City Of Fort Collins THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Puchasing Dept. ACCORDANCE WITH THE POLICY PROVISIONS. PO Box 580 AUTHORIZED REPRESENTATIVE Fort Collins, CO 80522 ACORD 25 (2009/09) ©1988.2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD