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Home My WebLink About114078 FRONT RANGE FIRE PROTECTION INC - INSURANCE CERTIFICATE (4)PINN/1 coy ASSURANCE U,01 � INSURED: Front Range Fire Protection Inc 4007 S Lincoln Ave Ste 460 Loveland, CO 80537 ENDORSEMENT: Blanket Waiver of Subrogation 7501 E Lowry Blvd Denver, CO 80230-7006 Phone: (303) 361-4000 / (800) 873-7242 Fax: (303) 361-5000 / (888) 329-2251 NCCI #: WC000313B Policy #: 1651212 AGENT: PFS Insurance Group, LLC - Johnstow 4848 Thompson Pkwy Suite 200 Johnstown, CO 80534 (970) 635-9400 We have the right to recover our payments from anyone liable for any injury covered by this policy. We will not enforce our right against the person or organization named in the schedule. This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us. This agreement shall not operate directly or indirectly to benefit anyone not named in the schedule. SCHEDULE To any person or organization when agreed to under a written contract or agreement, as defined above and with the insured, which is in effect and executed prior to any loss. Effective Date: May 31, 2012 Expires on June 1, 2013 Pinnacol Assurance has issued this endorsement May 31, 2012. Nichole Ellis Underwriter Pinnacol Assurance' 7501 E Lowry Blvd' Denver, CO 80230 Page 1 oft ELLISN- Undemrfvr 05/31/201209:40:4a 1651212 Updated: 05/09/2007 359-6 FKUN 1-8 UP IU: SL � o�Ro '4' CERTIFICATE OF LIABILITY INSURANCE DAT05/30/12 I 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 970-635-9400 CONTACT PFS Insurance Group - JT 4848 Thompson Pkwy, Ste 200 970-635-9401 Johnstown, CO 80534 Dave Janssen PHONE FAX LC No EaO: INC, No): E-MAIL ADDRESS: INSURER(S)AFFORDING COVERAGE NAICY INSURER A:PInnacolAssurance Co 1524210 INSURED Front Range Fire Protection, INSURERS: Everest Indemnity Ins. Company Inc' 4007 S Lincoln Ave., # 460 INSURER C : Everest National Ins Loveland, CO 80537-2503 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. XP INSR TYPE OF INSURANCE ADOLTISUBRI POLICY NUMBER MWDD/YYPOLICY FF MWDDIYPOLICY EYYY LIMITS LTR GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 B X COMMERCIAL GENERAL LIABILITY _il CLAIMSTdADE OCCUR 51GL0001672-121 06I01/12 06I01/13 DAMAGE TO RENTED -PREMISES (Ea occurrence) $ 50,00 MED EXP(Any one person) $ 5,000 PERSONAL B ADV INJURY $ 1,000,000 X Blanket Add'l Ins X Blanket Waiver GENERAL AGGREGATE $ 2,000,000 GEN'L AGGRE�GGAT�TE LIMIT APPLIES PER. PRODUCTS - COMP/OP AGG $ 2,000,000 IEI POLICY x l PRO 1 LOG IFCT $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident)$ 1,000,000 BODILY INJURY (Perperson) $ C X ANV AUTO 51CA000095.121 06/01/12 06/01/13 ALLOWNED SCHEDULED AUTOS AUTOS BODILVINJURV (Pe,.ccid.nt) $ PROPERTY DAMAGE Per accitlent $ 'ONOWNED X HIRED AUTOS X AUTOS Is BIkt AI Blkt Waive UMBRELLA UPS I OCCUR EACHOCCURRENCE $ 5,000,00 X gccREGATE $ 5,000,00 B EXCESS LIAB CLAIMSWADE 51CC000535-121 06/01/12 06/01/13 DED I X I RETENTION$ 10,000 $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETORIPARTNERIEXECUTIVE Y/N 1651212 06I01N2 06I01/13 � y � I I TH ^ ITORVLAMITSL��ER $ 500,000 EL. EACH ACCIDENT OFFICER/MEMBER EXCLUDED4 (Mandatory In NH) NIA E. L. DISEASE - EA EMPLOYEE $ 500,00 If yes, describe under DESCRIPTION OF OPERATIONS below E. L. DISEASE -POLICY LIMIT I$ 500,00 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is required) 1 Operations - All Locations CITYOFC 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 1D 1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD