HomeMy WebLinkAbout391001 WATERWISE LAND AND WATERSCAPES INC - INSURANCE CERTIFICATE (2)I
AC")?" CERTIFICATE OF LI!ABILITYINSURANCE DATE`MMIDDIYYYY)
`./ 1 03/30/2012
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS;NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR i:EGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOE.$ NOT CONSTITUTE A CONTRACT. BETWI'_EN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIf9CATE HOLDER. ' I
IMPORTANT: If the certificate holder is an ADDITION4L. INSURED, the policy(ies) must he-endoroed. If SW3ROGATION IS WAIVED, subject to
the terms and conditions of the policy, certain polir-ie:: may require an endorsements. A statementonJthis certificate does not confer rights to the
certificate holder in lieu of such endorsement(s). r"
PRODUCER -!� CONTACT
NAME' ___
Stansfield Insurance Agency PNONE g70.27a-0020 FAX Na 970-204-0305
5125 S College Ave, Suite B , i E-MAIL • I -
ADDRESS,
':• t :S
Fort Collins, CO 90525 ICI II 1 il,,, INSURERISIAFFORDING CO'✓EPAGE NAIC4
INSUREe A, Mid-Cerituri'lnsurance 121687
wsuREo '� : INSURER B: Truck iJJns_urrice Exchan�'_ _ 21709
Waterwise Land and Waterscapes Inc. INSURER C:ef
1121 N Lemay Ave INSURER D:.I'{,I,¢i:.i+l--
Ft Collins, CO 80524 , INSURER E: ..T:(' .)
INSURER F:_--- `
COVERAGES .".FRTIFICATF IJIIMRFR-. i- RFVIStrTN M1:Ipd RFR
THIS IS TO CERTIFY THA? THE Pr?L:Ca-- OF RU URANCE,LISTED 9'c LOW HAVE BEEN ISSUED'('. ' HE INSURED NAMED �GJVF_. FOR.' THE POLICY PERIOD
INDICATED. NOTWITHSTANDING ANY REGUIREMEDTf, TERM OR CONDITION OF ANY CONTRAC I' OR 041 ER DOCUMEN'! VI:H RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PCRTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH P::LICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY•PAID CLAIMS.
INSR
LTR
TYPE OF INSU0.ANCE
A DL
UBR I•�
!POLICY NUMBER
POLICYEFF
(MMIDDIYYYYI.IMMIDDiTTTYI
I POLICYEXI,
' LIMITS
A
GENERAL LIABILITY
604343i5M
03126/12:
03/25113
_
EACH OCCURRENCE
$1000000
X CObIMERCIAL GENERAL LIABILITY
03125/11 �,
103/25/112
DAMAGE .0_rtFNTED
PREM S ice rccurrence
$100 000
�
CLAIMS -MADE t "J OCCUR
tS
r 7 :
�f
I` Y
t 'I1d
MEC ER (Any one person)
11,000
X Products ColitolD-�
I;, ,:n. 1
,y '1?�
ll
PERSONALBADV INJURY
I$1000000
X
Broad Form
GENE SAL AGGREGATE
$2 QQQ QQQ
;:
�1
)
GE N'L AGGREGATE LIMIT APPLIES PER:
PRO-
i.. t
I'
pROCUCTS-COhIPIOP AGG
s2,000,000
POLICY X LOC
S
A
AUTOMOBILE LIABILITY
6043435321111
-�
03/2512`
03/203j
EO aL�NEOGNGLE LIMIT
1000QQQ
ANY Au.o
ALL OWNED .SCHEDULED
L X AUTO$ X AUTOS
'
dl =
r 1"
•
Iq
03/25111 '
03/25112)'
DODI YIN uav (Per parson)
BOOM INJURY (Per accident)
s
$
NON-0WNED
HIREDAUTOS AUTOS
y
1
I
I <
PROHETI DAMAGE
fP du lead
$
B
UMBRELLA LIAB X OCCUR
'E043489g6 it,
3/25/12
03/2I',13rl
EACH OCCURRENCE
$5000Q00
EXCESS LIAB CLAIMS -MADE
3/25/11'/
103/2b 12a
AGGR. AT_F._
55000000
I
DED RETENTION$
$
`!i
I i
4 1
B
WORKERS COMPENSATION
"Q4'165536
S'
Q4/15/12'" �u411!e 13;-
_
bl(STATD -' OTH-
X IGIIT R
AND EMPLOYERS' UABILITI' YIN
L'EAOH9_^:DENT
$1 QQQ QQQ
Q4/16/11�!�iiO4/15/12,.'
OFFICER/MEMBER EXNY OCODED?ECUTIVEO
NIA
,.
1
EL DISEASE-EAEMPLOYE
S1 000000
(Mandatory In NH)
.I�,�:: j
I- yyes, de scribe ender
p, _'
-- -
E.L. DISEASE -POLICY LIMIT $1 00Q 000
0 SCRIPTION OF OPERAI LL)^i5 below
�_�
Operations: Landscape
.. _J.I.
•.
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLE:! (Attach ACORD 101' AC01Dooal Remarks Schedule If more spaces Requ ini
• I' .til': R'' .4 I.
O t K nF ILA I E HOLOE K CANCELLATION'' ' -{
City of Ft Collins
PO Box 580 yt,• Ilif; SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
Ft Collins CO 80522 THE j t EXPIRATION' DATE' „THEREOF. NOTICE WILL BE DELIVERED IN
' ACCORDANCE WITH THE POLICY PROVISIONS.
.I AUTHORIZED REPRES`.NTATIVE r
1988-201h) ACORD,CORPORATION. All rights reserved.
ACORD 25 (2010/05) The ACORD name and logo are registered mat,; ; of ACORD. - _1
I i