HomeMy WebLinkAbout169120 AIR COMFORT INC - INSURANCE CERTIFICATE (7)Client#: 38722
AIRCO2
ACORD,., CERTIFICATE OF LIABILITY INSURANCE
DATE(MMIDD/YYYY)
06/01/2012
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR 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 B. Peterson ins., Inc.
P. O. Box 578
Greeley, CO 80632
970 356-0123
CONTACT NAME: Jennifer Winter
(PAID,"No Erin): ONE 970 506-3206 FAX No):970 506-6846
A/C,
ADDRESS: Jennifer.Winter@floodandpeterson.com
PAODU ER
CUSTOMER 10 p:
INSURER(S) AFFORDING COVERAGE
NAIC a
INSURED \ 1'� Air Comfort, Inc.
\\
150 Rome Court
INSURER A: Colorado Casualty Insurance
INSURER B: Pinnacol Assurance
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
TYPE OF INSURANCE
DEL
UBRI
POLICY NUMBER
MM/DDNYYY Y EFF
Y EXP
MM/DDNYYV
LIMITS
A
GENERAL LIABILITY
X COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE OCCUR
CBP8915817
6/01/201206/01/201
EACH OCCURRENCE
$1000000
TED
PREMISES EaoDAMAGE TO acurrence
$100000
MED EXP (Any one person)
$5,000
PERSONAL B ADV INJURY
$1,000,000
GENERAL AGGREGATE
s2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER.
POLICY X PRO LOC
PRODUCTS - COMP/OP AGO
$2,000,000
$
A
AUTOMOBILE
LIABILITY
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
AUTOS
BA8916017
6/01/2012
06/01/2012
COMBINED SINGLE LIMIT
(Ea accident)
$1.000.000
BODILY INJURY (Per person)
$
BODILY INJURY (Per accident)
$
1XX
PROPERTY DAMAGE
(Per accident)NON-OWNED
$
8
AhUMBRELLA
LIAB
EXCESS LIAB
X
OCCURC.U8915018
CLAIMS -MADE
6/01/2012
06/01/201
EACH OCCURRENCE
$4 000 000
AGGREGATE
$4 ODD DUD
DEDUCTIBLE
RETENTION 10000
$
$
B
WORKERS COMPENSATION
AND EMPLOYERS' UABILITY
ANY PROPRIETORIPARTNERIEXECUTIVEY/N
OFFICEWMEMBER EXCLUDED? F_N]
(Mandatory in NH)
It yes, describe under
DESCRIPTION OF OPERATIONS below
NIA
4041318
6/01/2012
06/01/2012
X JWG STATU- GTH-
E.L EACH ACCIDENT
$1 000000
E.L. DISEASE -EA EMPLOYEE
$1,000 000
E.L. DISEASE - POLICY LIMIT
$1 00D 000
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, N more space is required)
RE: Poudre Fire Authority #6, 102 Remington, Fort Collins, CO 80524
City of Fort Collins is listed as an Additional Insured as their interest may appear as respects General
Liability.
City of Fort Collins
Accounting Department
PO Box 580
Fort Collins, CO 80522.0580
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 1
#S699340/M699300
01988-2009 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD
JZS
Client#: 38722
AIRCO2
ACORD. CERTIFICATE OF LIABILITY INSURANCE
DATE(MMIDDnvvY)
06/01/2012
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR 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
970356-0123
CONTACT Jennifer Winter
NAME:
PHONE FAX
A/c Na Ert 970 506-3206 Arc, Na : 970 506-6846
gpoa'Ess: Jennifer.Winter@floodandpeterson.com
PRODUCER
CUSTOMER ID 0:
INSURER(S) AFFORDING COVERAGE
NAICIt
INSURED
Air Comfort, Inc.
150 Rome Court
INSURER A: Colorado Casualty Insurance
INSURER BPinnacol Assurance
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
TYPE OF INSURANCE
loo
SRD
POUCYNUMBER
DY
MWDNYY
POLICY
DYYLILL
LIMITS
A
GENERAL LIABILITY
X COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE [� OCCUR
CBP8915817
6/01/2012
06/01/2012
EACH OCCURRENCE
$1 000000
DAMAGE Ti
PREMISESEeoccurrerna
$100000
MED EXP (Any one person)
$5,000
PERSONAL & ADV INJURY
$1,000,000
GENERAL AGGREGATE
$2,000,000
GEN'L AGGREGATE LIMITAPPLIES PER:
POLICY X PRO- n LOC
JFDT
PRODUCTS - COMP/OP AGG
$2,000,000
$
A
AUTOMOBILE
LIABILITY
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
AUTOS
BA8916017
6/01/2012
06/01/2012
COMBINED SINGLE LIMIT
Fa accident
$1000000
BODILY INJURY (Per person)
$
BODILY INJURY (Per oxidant)S
1XX
PROPERTY DAMAGE
(Peracciden)NON-OWNED
$
$
A
X
UMBRELLA LIAB
EXCESS LIAB
X
OCCUR
CLAIMS -MADE
CUS915018
6/01/2012
06/01/201
EACH OCCURRENCE
$4 OOO OOO
AGGREGATE
s4,000,000
DEDUCTIBLE
RETENTION 10000
$
X
$
B
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITYER
ANY PROPRIETONPARTNEWEXECUTIVE Y/N
`MatlFICain Elo NH)BER EXCLUDED?
I es, describe under
DESCRIPTION OF OPERATIONS below
N/A
4041318
6/01/2012
06/01/201
X WCSTATU- 01
E.L. EACH ACCIDENT
$1000000
E.L. DISEASE - EA EMPLOYEE
$1,000,000
EL.DISEASE-POLICY LIMIT
$1,000,000
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Fernandina Schedule, N more apace is required)
Certificate Holder is named as an Additional Insured.
City of Fort Collins
PO Box 580
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
m1988-2009 ACORD CORPORATION. All rights reserved.
ACORD 25 (2009109) 1 Oil The ACORD name and logo are registered marks of ACORD
#S699338/M699300 JZS