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Home My WebLink AboutHAHN PLUMBING AND HEATING INC - INSURANCE CERTIFICATECERTIFICATE OF LIABILITY INSURANCE 06/21/D2012) 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 CONTACT NAME: Karole Peters aCONe,E,1:970.679.7355 acNe:866.237.2178 Ewing -Leavitt Insurance Agency 4025 St. Cloud Dr. Suite 100 Loveland, CO 80539 AIL ADDRESS: karole-peters@leavitt.com Prs000CER 00005246 CUSTOMER ID i INSURERS) AFFORDING COVERAGE NAIC If INSURED INSURERA: Secura Insurance 22543 Hahn Plumbing and Heating Inc. INSURER : Pinnacol Assurance 41190 PO Box 1924 INSURER C : FORT COLLINS, CO 80524-2403 INSURERD: INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: 11-12 w/12-13 WC 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 LTR TYPE OF INSURANCE ADDL INSR SUBR WVD POLICY NUMBER POLICY EFF MMIDDIYYYY POLICY EXP MMIDDIYYYY LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE I —XI OCCUR X Blkt Addl Insured TC315368609/01/2011 09/01/2012 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED PREMISES Ea occurrence) $ 100 00 , MED EXP(Any one person) $ 5,000 PERSONAL S ADV INJURY IS 1,000,000 X Blkt Waiver of Sub GENERAL AGGREGATE $ 2,000,00 GEN'L AGGREGATE LIMIT APPLIES PER: � PROPOLICY XIJIC F LOG PRODUCTS - COMPIOP AGG $ 2,000,00 A AUTOMOBILE X LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS A003153687 09101/2011 09/01/2012 CO aBINEDtSINGLE LIMIT (Ed $ 1,000,000 , 000, 00 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ X X $ A X UMBRELLALIAa E%CESS LIAB X OCCUR CLAIMS -MADE CU315368 '09101/2011 09101/2012 EACH OCCURRENCE $ 1,000,00 AGGREGATE $ 1,000,000 HXDEDUCTIBLE RETENTION $ 10,000, $ $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETORIPARTNERIEXECUTIVE❑ OFFICERIMEMBER EXCLUDED? (Mandatory In NH) If as, describe under CACRIPTIONOFOPERATIO NS below N I A 405921907101/2012 BLANKET WAIVEJ OF SUBROGATIO 07/01/20131 X I WCSTATU- OTH- TORY LIMITS ER EL EACH ACCIDENT $ 500,000 E.L. DISEASE - EA EMPLOYEE $ 500,000 E.L. DISEASE -POLICY LIMIT 1 $ 500,000 A Leased and Rented Equipment. TC315368609/01/2011 0910112012 Limit $25,000 $500 deductible DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is required) ity of Fort Collins is named as Additional Insured as regards the General Liability Policy. City of Fort Collins Utilities Dept. ATTN: Amber DeNooy P.O. Box 580 Fort Collins, CO 80522 I.NIV V CLLA I IUIN 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 0 ACORD 25 (2009/09) The ACORD name and logo are registered marks of ACORD