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HomeMy WebLinkAboutTHE BRICKMAN GROUP LTD - INSURANCE CERTIFICATE (2)A� �® CERTIFICATE OF LIABILITY INSURANCE Page I of 1 06/22/2n012 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 tothe certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Willie of Pennsylvania, Inc. c/o 26 Century Blvd. P. O. Box 305191 PHONE FAX 877-945-7378 888-467-2378 E-MAIL Certl flCate B@W11118. COm ADDRESS Nashville, TN 37230-5191 _ INSURER(S)AFFORDING COVERAGE NAIC# INSURERA: ACE American Insurance Company 22667-006 INSURED The eric]wan Group, Ltd. LLC INSURERB: American Guarantee & Liability Insurance 26247-005 WSURERC: Indemnity Insurance Company of North Amer 43575-001 18227-D Flower Hill Way Gaithersburg, ND 20879 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 18064614 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 rypE OFINSURANCE DD' SUBUSEU I POLICY NUMBER POLICY EFF POLICY EXP LIMITS A GENERAL LIABILITY XSLG27010684 7/1/2012 7/1/2013 EACH OCCURRENCE IS 21000,000 DAMAGE TO RENTED PREMISES Eaoccur.nce $ 2,000,000 X COMMERCIAL GENERAL LIABILITY MED EXP(Any one person) $ CLAIMS-MADE1`X1OCCUR PERSONAL& ADV INJURY $ 2,000,000 X Contr. Prof. Liab. X Pesticides E Herbice GENERALAGGREGATE $ 15,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 4,000,000 X POLICY PRO- LOC A AUTOMOBILE UABILIW ISAH0870928 7/1/2012 7/1/2013 CO arBo ED SINGLE LIMIT $ 1,000,000 BODI LY INJU RV(Per person) $ X ANVAUTO ALL OWNED SCHEDULED AUTOS AUTO BODILY INJURY(Per ( ) $ HIREDAUTOS NON-OWNEDS AUTOS PROPERTY DAMAGE (Paraccitlent) $ $ B X UMBRELLA LIAR X OCCUR AUC508596807 7/1/2012 7/1/2013 EACH OCCURRENCE $ 5,000,000 AGGREGATE $ 51000,000 EXCESS LIAB CLAIMS -MADE DEO RETENTION$ $ C WORKERS COMPENSATION AND EMPLOYERS'LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE[N] OFFICER/MEMBER E%CLUDEDP `Mandatory in NH) f yes, describe under N/A WLRC47121097 7/1/2012 7/1/2013 X A FH E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE -EA EMPLOYEE $ 1, 000, 000 E.L. DISEASE - POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS below A ISAH0870928 '7/1/2012 7/1/2013 Auto Physical Damage Actual Cash Value Less $1,000 All Owned and Leased Deductible Comp. 6 Coll. DESCRIPTION OF OPERATIONS/ LOCATIONS/VEHICLES (Attach Acord 101, Additonal Remarks Schedule, if more space is required) Limits include applicable retentions. Re:Old Town Square Irrigation System Proj c�#6084- City of Fort Collins and Downtown Development Authority are named as Additioith regards to General Liability. CITY OF FORT COLLINS PURCHASING DIVISION 215 NORTH MASON STREET 2ND FLOOR FORT COLLINS, CO 80524-4402 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 C011:3773007 Tpl:1470808 Cert:18064614 ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD NOTICE TO OTHERS ENDORSEMENT - SCHEDULE NOTICE BY INSURED'S REPRESENTATIVE Named Insured The Brickman Group Ltd. LLC Endorsement Number Policy Symbol Policy Number Policy Period Effective Date of Endorsement XSL G27010684 7/1/2012to 7/1/2013 7/1/12 ISA H0870928 Issued By (Name of Insurance Company) Ace American Insurance Company THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. A. If we cancel the Policy prior to its expiration date by notice to you or the first Named Insured for any reason other than nonpayment of premium, we will endeavor, as set out in this endorsement, to send written notice of cancellation, to the persons organizations listed in the schedule that you or your representative create or maintain (the "Schedule") by allowing your representative to send such notice to such persons or organizations. This notice will be in addition to our notice to you or the first Named Insured, and any other party whom we are required to notify by statute and in accordance with the cancellation provisions of the Policy. B. The notice referenced in the endorsement as provided by your representative is intended only to be a courtesy notification to the person(s) or organization(s) named in the Schedule in the event of a pending cancellation of coverage. We have no legal obligation of any kind to any such person(s) or organization(s). The failure to provide advance notification of cancellation to the person(s) or organization(s) shown in the Schedule will impose no obligation or liability of any kind upon us, our agents or representatives, will not extend any Policy cancellation date and will not negate any cancellation of the Policy. C. We are not responsible for verifying any information in any Schedule, nor are we responsible for any incorrect information that you or your representative may use. D. We will only be responsible for sending such notice to your representative, and your representative will in turn send the notice to the persons or organizations listed in the Schedule at least 30 days prior to the cancellation date applicable to the Policy. You will cooperate with us in providing the Schedule, or in causing your representative to provide the Schedule. E. This endorsement does not apply in the event that you cancel the Policy All other terms and conditions of the Policy remain unchanged. Authorized Representative ALL-32686 (01/11) Page 1 of 1 WILLIS CANCELLATION NOTICE NAMED INSURED POLICY NC The Brickman Group, Ltd. LLC 18227-D Flower Hill WayllGaithersburg, MD 208790 See Page 1 EFFECTIVE DATE SEE PAGE 1 Holder Name: CITY OF FORT COLLINS PURCHASING DIVISION 215 NORTH MASON STREET 2ND FLOOR FORT COLLINS, CO 80524-4402 Cancellation Terms IN ADDITION TO THE NOTICE PROVISIONS IN THE POLICY, WILLIS HAS AGREED WITH THE CARRIER THAT SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, WILLIS WILL SEND WRITTEN NOTICE TO THE CERTIFICATE HOLDER WITHIN 30 DAYS EXCEPT FOR NONPAYMENT OF PREMIUM. WILLIS WILL MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. Cancellation Terms Apply to the Following Coverages: General Liability and Automobile Liability Willis 102