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Home My WebLink About103009 PORTER INDUSTRIES - INSURANCE CERTIFICATEClient#: 14405 PORIN2 ACORDra CERTIFICATE OF LIABILITY INSURANCE (M DATEM/DD/YYYY) O6/21/2012 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 NAME: Kelly Beauvais PHONCEo Ext : A/C970 266-7121 Fax, a): 970 506-6846 A/N ADDRESS: kelly.beauvais@floodandpeterson.com R CUSTOMER to INSURERIS) AFFORDING COVERAGE NAICk INSURED INSURER A: Travelers Insurance Company Northern Colorado Cleaning, LLC dba Porter Industries INSURER BPinnacol Assurance 5202 Granite Street INSURER C Loveland, CO 80538 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 LUIL TYPE OF INSURANCE DDL UBR POLICY NUMBER MM/DDNYYY LICY EFF Y EXP PMMIDONYYY LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS MADEOCCUR P6302B955731 2/05/2012 02/05/201 EACH OCCURRENCE $1 000000 DAMAGE TO RENTED PREMISESEeocurence s300000 MED EXP(Any one person) $10,000 PERSONAL& ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE POLICY LIMIT APPLIES PER: X PRO LOC PRODUCTS - COMPIOP AGG $2,000,000 $ A AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS OWNED AUTOS P81026955731 2/05/2012 02t05/2013 COMBINED SINGLE LIMIT (Ea accident) $100D000 BODILY INJURY (Per person) $ BODILY INJURY(Per accident) S 1XX PROPERTY DAMAGE (Per accident)NON S S A X1 UMBRELLA LAB X EXCESS LIAR OCCUR CLAIMS MADE PSMCUP2B955731 2/05/2012 02/05/2013 EACH OCCURRENCE S1,000,000 AGGREGATE $1,000,000 DEDUCTIBLE RETENTION $ $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOWPARTNEWEXECUTIVEY/N OFFICEWMEMBER EXCLUDED? (Mandatory in NH) It Kee, deecnbe under DESCRIPTION OF OPERATIONS below N/A 4153522 7/01/2012 07/01/201 X WC STATU- OTH- E.L. EACH ACCIDENT $1000000 E.L. DISEASE - EA EMPLOYEE $1,000,000 E.L. DISEASE -POLICY LIMIT $1000000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) City of Fort Collins is listed as an Additional Insured as their interest may appear as respects General Liability. City of Fort Collins YAC PO Box 580 Fort Collins, CO 80524 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 @1988.2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009/09) 1 Oft #S705085/M705055 The ACORD name and logo are registered marks of ACORD NIK Clii 14405 17i111@C7 ACORDrN CERTIFICATE OF LIABILITY INSURANCE DATE""" F O6/21/2012 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 NAME: Kelly Beauvais vNONE 9 70 266-7121 FAX 970 506-6646 A/C No Est No1. lelly.beauvais@floodandpeterson.com nooRess: kelly.beauvais@floodandpeterson.com PRODUCER CUSTOMER ID#: INSURERS) AFFORDING COVERAGE NAIC# INSURED INSURER A: Travelers Insurance Company Northern Colorado Cleaning, LLC dba Porter Industries INSURER BPinnacol Assurance 5202 Granite Street INSURER C Loveland, CO 80538 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. L R TYPE OF INSURANCE DOL UBR POLICY NUMBER (Mda nvvY POLICY EXP (MM/DDNYYYI LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE I -XI OCCUR P6302B955731 2/05/2012 02/05/2012 EACH OCCURRENCE $1 000 000 PREMISES Eaoccu ante $300000 MED EXP (Anyone person) $10,000 PERSONAL &ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE 17 POLICY LIMIT APPLIES PER: X PRO- n LGC ECT PRODUCTS - COMP/OP AGO $2,000,000 $ A AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS P8102B955731 2/05/2012 02105/2012 COMBINED SINGLE LIMIT (Ea accident) $1,000,000 X BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ X X $ $ A X UMBRELLA LIAB EXCESS LIAB )( OCCUR DLAIMS-MADE PSMCUP2B955731 2/05/201202105/201 EACH OCCURRENCE $1000000 AGGREGATE $1000000 DEDUCTIBLE RETENTION $ $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETORIPARTNER/EXECUTIVEY/N OFFICER/MEMBER EXCLUDED? (Myyandri In NH) If ❑Ees, describe ..der SCR PTION OF OPERATIONS below N/A 4153522 7/01/2012 07/01/201 X WCSTATIJ TOP,OTH- E.L. EACH ACCIDENT $1000000 E.L. DISEASEEAEMPLOYEE $1,000,000 E.L. DISEASEPOLICYLIMIT $1000000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, N more space is required) RE: 6120 Carpet Maintenance City of Fort Collins is listed as an Additional Insured as their interest may appear as respects General Liability. City of Fort Collins Purchasing Department PO Box 580 Fort Collins, CO 80524 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 44.«14SL_ 01988.2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009/09) 1 of 1 #S705095/M705055 The ACORD name and logo are registered marks of ACORD NIK Client#: 14405 3f791.[7 ACORD. CERTIFICATE OF LIABILITY INSURANCE Dos/21/20012YY) 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 NAME: Kelly Beauvais PNCONEo 970 266-7121 FAX , A/ NExt : A/CNo 970 506-6846 EMAIL ADDRESS: Y• P kell beauvais@floodand eterson.com FHnJVUULK CUSTOMER ID M: INSURER(S) AFFORDING COVERAGE NAICN INSURED INSURER A: Travelers Insurance Company Northern Colorado Cleaning, LLC dba Porter Industries INSURER BPinnacol Assurance 5202 Granite Street INSURER C Loveland, CO 80538 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. 1NSR TYPE OF INSURANCE DDL UBR POLICY NUMBER MM%DD/YYYY MM/DDNYYY LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE F_x� OCCUR I P630213955731 2/05/2012 02105/2013 EACH OCCURRENCE $1 000 000 DAMAGE TO R PREMISES Eaoccu ante $30D000 MED EXP (Any one person) $10,000 PERSONAL S ADV INJURY $1,000,000 GENERAL AGGREGATE $2 000 000 GEN'L AGGREGATE POLICY LIMIT APPLIES PER: X PRO- n LOC PRODUCTS - COMP/OP AGG s2,000,000 $ A AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS P810213955731 2/05/2012 02/05/2013 COMBINED SINGLE LIMIT (Ea accident) $1,000.000 X BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ X X $ $ A X UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE PSMCUP2B955731 0210512012 OIJ0512013 EACH OCCURRENCE $1,000,000 AGGREGATE $1,000,000 DEDUCTIBLE RETENTION $ $ B WOR HERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVEY/N OFFICERIMEMBER EXCLUDED? (Mandator, In NH) If ydes cribe scribe under DESCRIPTION OF OPERATIONS below WA 4153522 7/01/2012 07/01/201 X WCSTATU- OTH- E.L. EACH ACCIDENT $11000000 E.L. DISEASE - EA EMPLOYEE $1,000,000 E.L. DISEASE -POLICY LIMIT $1000000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES Judson ACORD 101, Additional Remarks Schedule, B more space is required) City of Fort Collins is listed as an Additional Insured as their interest may appear as respects General Liability. City of Fort Collins Senior Center SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. PO Box 580 Fort Collins, CO 80524 AUTHORIZED REPRESENTATIVE Q6 ;7Ee.H�sc_ 01988-2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009109) 1 of 1 The ACORD name and logo are registered marks of ACORD #S705096/M705055 NIK Client#: 14405 PORIN2 ACORD. CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) F O6/21/2012 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 970 356-0123 CONTACT NAME: Kelly Beauvais PHONE F" Arc No Est : 970 266-7121 Arc, a): 970 506-6846 -M^ kell beauvais�floodand eterson.com ADOREss: R P PRODUCER CUSTOMER ID a: INSURER(S) AFFORDING COVERAGE NAIC R INSURED INSURER A: Travelers Insurance Company Northern Colorado Cleaning, LLC dba Porter Industries INSURER B: Pinnacol Assurance 5202 Granite Street INSURER C: Loveland, CO 80538 INSURER D: INSURER E: INSURER F COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THATTHE 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 DDL UBfl POLICY NUMBER LICY EFF MAVODNYYY POLICY EXP MM/OD/YYYY LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS MADE r X] OCCUR P6302B955731 2/05/2012 02/05/2013 EACH OCCURRENCE $1 000 000 Ea occur ence $300OOO -PREMISES MED EXP (Anyone person) $10,000 PERSONAL &ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 GEN'L AGGRI TELIMIT APPLIES PER: POLICY X PRO n LOC PRODUCTS - COMP/OP AGO s2,000,000 $ A AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIREDAUTOS NON -OWNED AUTOS P810213955731 2/05/2012 02/05/2013 COMBINED INGLE LIMIT $1,000,000 X BODILY INJURY (Per pe50n) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ 1XX $ A UMBRELLA LIAR EXCESS LIAB X OCCUR CLAIMS -MADE PSMCUP2B955731 2t05/2012 02/05/2013 EACH OCCURRENCE $1 OOOOOO AGGREGATE $1000000 DEDUCTIBLE RETENTION $ $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETORVPARTNERJEXECUTIVEY/N OFFICERIMEMBER EXCLUDED? (Mandator, In NH) If yes, describe under DESCRIPTION OF OPERATIONS below NIA 4153522 7/01/2012 07/01/201 X WCSTATU-I I OTH- E.L. EACH ACCIDENT $1000000 E.L. DISEASE CA EMPLOYEE $1 ,000,000 E.L. DISEASE - POLICY LIMIT $1000000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Anath ACORD 101, Additional Remarks Schedule, N more space is required) RE: Carpet Maintenance Certificate holder is included as Additional Insured as required by written contract with respects to liability arising out of work performed by the named insured. City of Fort Collins Attn: James B O'Neill I SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 215 North Mason Street Second Floor PO Box 580 1 AUTHORIZED REPRESENTATIVE Fort Collins, CO 80522 01988.2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009/09) 1 of 1 The ACORD name and logo are registered marks of ACORD #S705086/M705055 NIK ClipntN: 16605 3ff1:11IN ACORD. CERTIFICATE OF LIABILITY INSURANCE °06/21/2012""' 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 970 356-0123 CONTACT NAME: Kelly Beauvais PHONE g70 266-7121 nx 970 506-6846 A/C No EXt : A/C, No E-MAIL kelly.beauvais@floodandpeterson.com CUSTOMER ID #: INSURER(S) AFFORDING COVERAGE NAIC # INSURED INSURER A: Travelers Insurance Company Northern Colorado Cleaning, LLC dba Porter Industries INSURERS: Pinnacol Assurance 5202 Granite Street INSURER C: Loveland, CO 80538 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. INS- TYPE OF INSURANCE DDL VD POLICY NUMBER MM%DDNYY MMIDD/YYYY LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE Fifl OCCUR P6302B955731 2/05/2012 02/05/2013 EACH OCCURRENCE $1 DDD 000 PREMISES Ea OLLUrmnce $300DDD MED EXP(Anyone person) $10,000 PERSONAL &ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: 17 POLICY X PRO LOC PRODUCTS COMP/OP AGO $2,000,000 $ A AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOOPROPERTY HIRED AUTOS NON -OWNED AUTOS P8102B955731 2/05/2012 02105/2013 COMBINED O aBl)INEDSINGLE LIMIT $(Ea1,000,000 BODILY INJURY (Per person) $ BODILY INJURY(Per awdenl) $ 1XX DAMAGE (Per accident) $ $ A I XI UMBRELLA LIAR EXC EBB DAB X OCCUR CIAIMS-MADE PSMCUP2B955731 21`05/2012 02/05/2013 EACH OCCURRENCE $1000000 AGGREGATE $1 000000 DEDUCTIBLE RETENTION S $ $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNERJEXECUTIVEY/N OFFICER/MEMBER EXCLUDED? ❑N (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below WA 415535522 7/0112D12 D7/D1/201 OTH- X WC STATU- IF E.L. EACH ACCIDENT $1 000,000 E.L. DISEASEEAEMPLOYEE $1,000,000 E.L. DISEASE -POLICY LIMIT $1000000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101. Additional Remarks Schedule, if more space is required) City of Fort Collins Building & Permit Dept. Fossil Ridge Maintenance 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 01988-2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009/09) 1 of 1 #S705087/M705055 The ACORD name and logo are registered marks of ACORD NIK Clientg: 14405 IIH:104 ACORD,,. CERTIFICATE OF LIABILITY INSURANCE GATEO6/1/2021/20/V2 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 such endorsement(s). PRODUCER Flood & Peterson lns.,Inc. P. O. Box 578 Greeley, CO 80632 970356-0123 CONTACT NAME: Kelly Beauvais AP/C RONEo 970 266-7121 FAX, NExt: A/CNo: 970 506-6846 ADD ESS. kelly.beauvais@floodandpeterson.com FHuuuutm CUSTOMERID#: INSURER(S) AFFORDING COVERAGE NAIL# INSURED INSURER A: Travelers Insurance Company Northern Colorado Cleaning, LLC dba Porter Industries INSURER BPinnacol Assurance 5202 Granite Street INSURER C Loveland, CO 80538 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 DOL UBRI POLICY NUMBER POLICY EFF MM/DO/YYYV POLICY EXP /Y MWODYYY LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE I OCCUR P6302B955731 2/05/2012 02/05/2012 EACH OCCURRENCE $1 00D 000 PREMISES Ea occurrence) s300000 MED EXP (Any one person) $10,000 PERSONAL B ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE POLICY LIMIT APPLIES PER X PRO- 71 LOG PRODUCTS - COMP/OP AGG $2,000,000 $ A AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS AUTOS P8102B955731 2/05/2012 02/0512012 COMBINED SINGLE LIMIT (Ea accident) $1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ 1XX PROPERTY DAMAGE (Per code ni)NON-OWNED $ $ A )( UMBRELLALIAB EXCESS LIAR X OCCUR CLAIMS -MADE PSMCUP2B955731 2105/2012 02/05/2013 EACH OCCURRENCE $1000000 AGGREGATE $1000000 DEDUCTIBLE RETENTION $ $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECURVE 7N OFFICER/MEMBER EXCLUDED? N (Mandatory in NH) If yes, describe under DE SC PINION OF OPERATIONS below N/A 4153522 7/01/201207/01/201 X WC STATU- OTH- FR E.L. EACH ACCIDENT $1 000000 E.L. DISEASE - EA EMPLOYEEI $1,000,000 E. L. DISEASE -POLICY LIMIT 1 $1000000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, U more space is required) City of Fort Collins Carpet Maintenance P SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. PO Box 580 Fort Collins, CO 80522 AUTHORIZED REPRESENTATIVE Qcr 01988-2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009/09) 1 of 1 The ACORD name and logo are registered marks of ACORD #S705088/M705055 NIK Client#: 14405 PORIN2 ACORD,., CERTIFICATE OF LIABILITY INSURANCE DATE(MM/OD/YYYY) 06/21/2012 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 970 356-0123 CONTACT NAME: Kelly Beauvais PHONE g70 266-7121 FAX A/C No Est : A/C, No 970 506-6846 AOCRESS kelly.beauvais@floodandpeterson.com PRODUCER CUSTOMER ID r: INSURER(S) AFFORDING COVERAGE NAIC a INSURED INSURER A: Travelers Insurance Company Northern Colorado Cleaning, LLC dba Porter Industries INSURER B Pinnacol Assurance 5202 Granite Street INSURER C Loveland, CO 80538 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 LUL TYPE OF INSURANCE DDL UBR POLICY NUMBER MM/DDPOLICY EFF /YYYY (MWDDNYYY LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE X] OCCUR P6302B955731 2/05/2012 02105/2012 EACH OCCURRENCE $1 000 0O0 DAMAGE T RENTED PREMISES Erro..nencen s3000OO MED EXP (Any one peson) $10,000 PERSONAL d ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE 17 POLICY X LIMIT APPLIES PER: PRO 71 LOC PRODUCTS - COMP/OP AGG $2,000,000 $ A AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIREDAUTOS NON -OWNED AUTOS P8102B955731 2/05/2012 02/05/2012 COMBINED SINGLE LIMIT Fs accident) $1 DODOOD BODILY INJURY (Per person) $ BODILY INJURY (Per acaidenl) $ 1XX PROPERTY DAMAGE (Per accident)$ $ $ A )( UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE PSMCUP2B955731 2/05/201202105/201 EACH OCCURRENCE $1000000 AGGREGATE $1000000 DEDUCTIBLE RETENTION $ $ B WORKERS COMPENSATION AND EMPLOYERS'LIABILITY Y/NER ANY PROPRIETORTARTNER,EXECUTIVE❑ OFFICERIMEMBER EXCLUDED? N (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N/A 4153522 7/01/201207/01/2D1 X WC $TATUT OTH- FR E L. EACH ACCIDENT $1,000,000 EL. DISEASE - EA EMPLOYEE $1,000,000 E.L. DISEASE -POLICY LIMIT $1000000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, N more apace is required) City of Fort Collins is listed as an Additional Insured as their interest may appear as respects General Liability. City of Fort Collins Custodial Services PO Box 580 Fort Collins, CO 80524 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 444-/' 4L_ @1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009/09) 1 Oil #S705089/M705055 The ACORD name and logo are registered marks of ACORD NIK Clientg- 14405 PORIN2 ACORD. CERTIFICATE OF LIABILITY INSURANCE D TE(MMMDNYYY) 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 970 356-0123 CONTACT NAME: Kelly Beauvais PA/HOCNEo 970 266-7121 FA" NH : A/C.No 970 506-6846 E ADDRIESS: kelly.beauvais@floodandpeterson.com CUSTOMER ID N: INSURER(S) AFFORDING COVERAGE NAIC N INSURED INSURER A: Travelers Insurance Company Northern Colorado Cleaning, LLC dba Porter Industries INSURER B: Pinnacol Assurance 5202 Granite Street INSURER C: Loveland, CO 80538 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 NDDCY SR VD POLICY NUMBER EFF MMIDDNYYY POLICY EXP MM/DDNYYY LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE F OCCUR P6302B955731 2105/2012 02/05/2013 EACH OCCURRENCE $1000000 DAMAGE T3 RENTED PREMISES Ea ccunance s300000 MED EXP (Any one person) $10,000 PERSONAL &ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRO* F LOC POLICY X JECT PRODUCTS - COMP/OP AGG $2,000,000 $ A AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON-OWNEDAUTOS P810213955731 2/05/2012 02/05/2013 COMBINED SINGLE LIMIT (Ea accident) $1000000 BODILY INJURY(Per person) $ BODILY INJURY(Per accident) $ 1XX PROPERTY DAMAGE (Per accident) $ $ A I XI UMBRELLA L'AB EXCESS LIAB X OCCUR CLAIMS -MADE PSMCUP2B955731 2105/201202/05/201 EACH OCCURRENCE $1000000 AGGREGATE $1000000 DEDUCTIBLE RETENTION $ $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY IN ANYPROPRIETORIPARTNER/EXECUTIVE Y OFFICER/MEMBEREXCLUDED? (Mandatory in NH) 11yes, describe under OE SC RIPTION OF OPERATIONS below N/A 4153522 7/01/2012 07/01/201 X WC STATD- OTH- E.L. EACH ACCIDENT $1000000 E.L. DISEASE - EA EMPLOYEEI $11000,000 E.L. DISEASE -POLICY LIMIT $1000000 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (Anach ACORD 101, Additional Remarks Schedule, if more space is required) City of Fort Collins is listed as Additional Insured as their interest may appear as respects General Liability. City of Fort Collins SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE EPIC Center THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. PO Box 580 Fort Collins, CO 80522 AUTHORIZED REPRESENTATIVE L./C7 @1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009/09) 1 Of 1 The ACORD name and logo are registered marks of ACORD #S705O9OtM705055 NIK Client#: 14405 PORIN2 ACORD. CERTIFICATE OF LIABILITY INSURANCE DATEIMM/DDNYYY) F 06/21/2012 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 NAME: Kelly Beauvais PHONE FAX A/c No Ert : 970 266-7121 Arc, No): 970 506-6846 E-MA, kell beauvais@floodand eterson.com ADDREss: y P PRODUCER CUSTOMER ID p: INSURERIS) AFFORDING COVERAGE NAICIt INSURED INSURER A: Travelers Insurance Company Northern Colorado Cleaning, LLC dba Porter Industries INSURER BPinnacol Assurance 5202 Granite Street INSURER C Loveland, CO 80538 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 DDL UBR POLICY NUMBER MWD�/YYYY CY EXP MMIDONYYY LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR P630291955731 2/05/2012 02/05/2013 EACH OCCURRENCE $1 00O 000 MAGE TO RENTE PREMSES Ea occurence $300000 MED EXP(Anyone Person) $10,000 PERSONAL 8 ADV INJURY $1,000 000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE POLICY LIMIT APPLIES PER: X PRO- LOC PRODUCTS-COMP/OPAGG $2,000,000 $ A AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS P8102B955731 2/05/2012 02105/2013 COMBINED SINGLE LIMIT Ea accident) $1,000,000 X BODILY INJURY (Per Person) S BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ X X $ A X UMBRELLA LIAR EXCESS LIAR X OCCUR CLAIMS -MADE PSMCUP2B955731 2/05/201202/05/201 EACH OCCURRENCE $1000000 AGGREGATE $1000000 DEDUCTIBLE RETENTION $ $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITYIMES ANY PROPRIETORN /PARTNERIEXECUTIVE — OFFICEP/MEMBER EXCLUDED? (Mandatory In NH) If yyes, describe under DESORIPTION OF OPERATIONS below N/A I 4153522 7/01/2012 07/01/201 X WC STATU- OTH- OR E.L. EACH ACCIDENT $1000000 E.L. DISEASE - EA EMPLOYEE $1000000 E.L. DISEASE -POLICY LIMIT S1000000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, it more space is required) City of Fort Collins is listed as an Additional Insured as their interest may appear as respects General Liability. City of Fort Collins Lincoln Center PO Box 580 Fort Collins, CO 80524 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 (2009/09) 1 of 1 #S705O92tM705055 The ACORD name and logo are registered marks of ACORD i" Client#: 14405 I3U:111K ACORD. CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) O6/21/2012 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 970 356-0123 CONTACT NAME: Kelly Beauvais PHONE g70 266-7121 FAX g70 5D6.6846 A/C No Ext : A/C, No ADDRESS: kelly.beauvais@floodandpeterson.com PRODUCER CUSTOMER ID k: INSURER(S) AFFORDING COVERAGE NAIL e INSURED INSURER A: Travelers Insurance Company Northern Colorado Cleaning, LLC dba Porter Industries INSURER B: Pinnacol Assurance 5202 Granite Street INSURER C: Loveland, CO 80538 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 ODL UBR POLICY NUMBER MM/DD/YYYY POLICY EFF MMADDNYYY LIMITS A GENERALLIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR P63028955731 2/05/2012 02105/2013 EACH OCCURRENCE $1000000 DAMAGE PREMISES occur ante $300 000 MOD EXP(Any one person) $10,000 PERSONAL &ADV INJURY $1,000,000 GENERAL AGGREGATE s2,000,000 GEN'L AGGREGATE POLICY X LIMITAPPLIES PER: PRO- n LOC PCT PRODUCTS - COMP/OP AGG $2,000,000 $ A AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS P8102B955731 2/05/2012 02/05/2013 COMBINED SINGLE LIMIT (Ea accident) $1000000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) S 1XX PROPERTY DAMAGE (Per accident) $ $ A X UMBRELLA LIAR EXCESS LIAB X OGGUR CLAIMS -MADE PSMCUP213955731 2/05/201202105/201 EACH OCCURRENCE $1000000 AGGREGATE $1,000,000 DEDUCTIBLE RETENTION $ $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOWPARTNERIEXECUTIVEY/N OFFICER/MEMBER EXCLUDED? F (MyIPandator, in NH) IDEScaldr, ..der CRIPTION OF OPERATIONS below N/A 4153522 7/01/2012 07/01/201 X WC STATU- OTP_ E.L. EACH ACCIDENT $1000000 E.L. DISEASE - EA EMPLOYEE $1,000,000 E.L. DISEASE -POLICY LIMIT $1000000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, U more space is required) City of Fort Collins is listed as an Additional Insured as their interest may appear as respects General Liability. City of Fort Collins Mulberry Pool PO Box 580 Fort Collins, CO 80524 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. #4 ,ri4sc_ @ 1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009/09) 1 of 1 #S705093/M705055 The ACORD name and logo are registered marks of ACORD ww Client#: 14405 PORIN2 ACORD,. CERTIFICATE OF LIABILITY INSURANCE _DATE/21/2012""' 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 INSURERS), 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 970 356-0123 CONTACT NAME: Kelly Beauvais PHONNEo -7121 FAX, : 970 266A/CNo : 970 506-6846 ADREst DESS: kelly.beauvais@floodandpeterson.com PRODUCER CUSTOMER ID If INSURER(5)AFFORDING COVERAGE NAICN INSURED Northern Colorado Cleaning, LLC dba Porter Industries INSURER A: Travelers Insurance Company INSURER BPinnacol Assurance 5202 Granite Street INSURER C Loveland, CO 80538 INSURER 0: 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 DDL UBR POLICY NUMBER POLICY EFF MWDD/YYYY POLICY EXP MM/DDNYYV UNITS A GENERAL LIABILITY X COMMERCIAL GENERALLIABILITY CLAIMS -MADE � OCCUR P6302B955731 2/05/2012 02/05/2013 EACH OCCURRENCE $1 000 000 DAMAGE TO RETED PREMISES (Ed occurrrence s3000OO MED EXP (Anyone person) $10,000 PERSONAL &ADV INJURY $1 000000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE POLICY X LIMITAPPLIES PER: PHI- n LOG JFCT PRODUCTS - COMP/OP AGG $2,000000 $ A AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS P8102B955731 2/05/2012 02/05/201 2 COMBINED SINGLE LIMIT (Ea accident) $1,000,000 BODILY INJURY(Per person) $ BODILY INJURY(Per accident) $ 1XX PROPERTY DAMAGE (Pviloali $ $ $ A X UMBRELLA LIAR EXCESS LIAR X OCCUR CLAIMS -MADE PSMCUP2B955731 2/05/201202/05/201 EACH OCCURRENCE $1000000 AGGREGATE $1 000 000 DEDUCTIBLE RETENTION $ $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITYFR ANY PROPRIETOR/PARTNEWEXECUTIVEV/N OFFICERIMEMBER EXCLUDED? F_N] (Mandalory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N/A 4153522 7/01/2012 07/01/201 X WCSTATU- OTH- E.L. EACH ACCIDENT $1,o00000 E.L. DISEASE - EA EMPLOYEE $1,000,000 E.L. DISEASE -POLICY LIMIT $1 00O 000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, H more space is required) City of Fort Collins is listed as an Additional Insured as their interest may appear as respects General Liability. City of Fort Collins Northside PO Box 580 Fort Collins, CO 80524 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 @1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009/09) 1 Of 1 #S705094/M705055 The ACORD name and logo are registered marks of ACORD NIK