HomeMy WebLinkAbout128847 CRYSTAL LANDSCAPE SUPPLIES INC - INSURANCE CERTIFICATE (2)UP IU:
CERTIFICATE OF LIABILITY INSURANCE DATE 1 8112
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 WANED, 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
PRODUCER 970-635-940C
PFS Insurance Group - JT
$848 Thompson Pkwy, Ste 200 970-635-9401
Johnstown, CO 80534
Keith Benner
INSURED Crystal Landscape Supplies Inc INSURER A: Plnnacol Assurance 524210
6616 N. Garfield Ave. h�g� INSURER B: Allied Insurance Company 19100
Loveland, CO 80538-1115
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.
I S TYPE OF INSURANCE AOORL11M RI POLICY NUMBER MMIDDY/YYYYM/DDYWVY LIMITS
GENERAL LIABILITY
EACH OCCURRENCE
$ 1,000r000
B
X COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE a OCCUR
ACPGLA07543108871
12I01111
12I01112
DAMAGE TO RENTED
PREMISES IEaoccurrence)
1 $ 100,000
MED EXP (Any one person)
$ 5,00
X Blkt Al by Agree
PERSONAL S ADV INJURY
I $ 1,000,00
GENERAL AGGREGATE
$ 2,000,00
GEN'L AGGREGATE LIMIT APPLIES PER:
PRODUCTS - COMP/OP AGG
$ 2,000,00
I
X POLICY PRO r LOC
$
B
AUTOMOBILE
LIABILITY
ANY AUTO
ACPBA75431008871
12/01/11
12/01/12
COMBINED SINGLE LIMIT
(Ea accident)
$ 1,000,00
X
BODILY INJURY (Per person)
$
ALL OWNED AUTOS
BODILY INJURY (Per accident)
$
SCHEDULEDAUTOS
HIREDAUTOS
PROPERTY DAMAGE
(Per accident)
$
X
X
NON-OWNEDAUTOS
Comp bad
s 1,00
Coll Ded
$ 1,00
LIAB
UMBRELLA
OCCUR
CIMS-MADE
EACH OCCURRENCE
$
�
AGGREGATE
EXCESS LIARO
NIA
DEDUCTIBLE
$
$
RETENTION $
A
WORKERS COMPENSATION
ANDEMPLOYERS'LIABILITY
ANY PROPRIEZORIPARTNEREXECUTIVE YIN
OFFICER/MEMBER EXCLUDED?
(Mandatory In Ni
If describe under
DE SCRIPTION OF OPERATIONS below
NIA
4041312
06/01/12
06/01/13
WC STATU- I IOTH-
X TORY-LIMITS L�ER
E.L. EACH ACCIDENT
$ 100,000
E.L. DISEASE -EA EMPLOYEE'$
100,00
E. L. DISEASE -POLICY LIMIT $ 500,000
B Ilnland
Marine
12/01/11
12/01/12
595,8802
IACPCIM7643108871
I
IDedlpment
DESCRIPTION OF OPERATIONS I LOCATIONS 1 VEHICLES (Attach ACORD 101, Additional Remarks Schedule, it more space Is required)
If required by written contract or written agreement, the City of Fort
Collins is included as Additional Insured for ongoing operations under
General Liability.
CITYOFC
City of Fort Collins
215 North Mason Street
Fort Collins, CO 80524
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WALL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE
U 1983-2009 ACORD CORPORATION. All rights reserved.
ACORD 25 (2009/09) The ACORD name and logo are registered marks of ACORD