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Home My WebLink About111134 MILL BROTHERS LANDSCAPE & NURSERY - INSURANCE CERTIFICATE (2)./� UP IU: RG CERTIFICATE OF LIABILITY INSURANCE DAT06/28/12 ) 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 970-635-940C PFS Insurance Group -J7 970-635-9401 4848 Thompson Pkwy, Ste 200 Johnstown, CO 80534 Dave Janssen INSURED Mill Brothers Landscape 8. Nursery, Inc., MB Design Group & ME Golf 6121 E. Harmony Road Fort Collins, CO 80528 INSURERA -Travelers Indemnity Com 25615 INSURER aPinnacol Assurance 141190 1 INSURER D: 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. ILTR TYPE OF INSURANCE ADDLI MID POLICY NUMBER MMIDD—POUCmn MtdlLppYY=Xp LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE FxI OCCUR X I Blanket Add'I Ins C06764N559 07/01/12 07/01/13 EACH OCCURRENCE DAMAGE TO RENTED PREMISES_( Ea occurrence) MED EXP (Any one person) S 1,000,000 $ 300,000 I $ 5,000 PERSONAL S ADV INJURY $ 1,000,00 X Blanket Waiver GENERAL AGGREGATE $ 2,000,00 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY /l PRO LOG PRODUCTS AGG $ 2,000,00 $ A A A AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIREDAUTOS NON-OWNEDAUTOS 8106764N559 07/01/12 07/01/13 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,00 X BODILY INJURY (Per person) $ BODILY INJURY (Per accitlenl) $ PROPERTY DAMAGE (Peraccidem) $ X X Is Is A UMBRELLA LIAB E%CESS LIAR X OCCUR CLAIMS -MADE CUP6764N559 07/01/12 07/01/13 EACH OCCURRENCE $ 2,000,000 AGGREGATE $ 2,000,000 DeoucneLE RETENTION $ s g B WORKERS COMPENSATION ANDEMPLOYERS 'LIABILITY YIN ANY PROPRIETOWARTNERIEXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below NIA 3037054 BLANKET WANER OF SUBRO 07/01/12 07/01/13 WC STATU- OTH- X TO —LIMITS ER EL. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,00 E.L. DISEASE -POLICY LIMIT I$ 1,000,000 I DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is required) RE: 7034 Cottonwood Glen Overflow Parking Lot Landscape 6 irrigation. The City, its officers, agents and employees (see note attached) CITYFT3 City of Fort Collins P.O. Box 580 Ft. 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 /4 �a+� OO 1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009/09) The ACORD name and logo are registered marks of ACORD NOTEPAD. HOLDER CODE CITYFT3 MILLB-2 PAGE 2 INSURED'S NAME Mill Brothers Landscape & OP ID: RC DATE red over