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Home My WebLink About125758 FULLER LANDSCAPING LLC - INSURANCE CERTIFICATEBank of the West 7/23/2012 11:46:15 AM PAGE 1/002 Fax Server DIE500D397A9544 COLORADO- FAX TRANSMITTAL COVER BW INSURANCE .rt AGENCY TO Name City of Fort Collins Company/ Department Voice Phone Fax 919702216707 Phone Date: Monday, July 23, 2012 11:45:54 AM Message: From: Name Matt Diemer Voice 970-267-2226 Phone Fax 86834 Phone Email Matt.Diemer@bankofthewest.com 1075 W Horsetooth Rd. Ste 106 Address Fort Collins CO 80526 Number of pages, including Cover Sheet: 02 This fax is for the personal and exclusive use of the recipient to whom it is addressed. It contains confidential information from the sender. Its contents are to remain absolutely confidential and may also be subject to the attorney -client privilege. If you have received this transmission and are not the intended recipient(s) or his/her agent, please be advised that any disclosure, use, review, copying, selling, dissemination, publication or distribution of this transmission is unauthorized and prohibited. If you have received this transmission in error, please notify the sender immediately by telephone and return the original facsimile to the sender by U.S. Mail. Thank you. Insurance and Investment products are not a deposit or other obligation of, or guaranteed by the bank or its affiliates. Insurance and annuity investments are not insured by the FDIC or any other agency of the U.S., the bank, or any of its affiliates. Insurance and Investment products may lose value. (t 2/05) Bank of the West DIE50OD397A9544 7/23/2012 11:46:15 AM PAGE 2/002 Fax Server A1* Rom CERTIFICATE OF LIABILITY INSURANCE 7/23/2012YY) 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: It the cerlificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. It SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this cerlificate does not confer rights to the cerlificate holder in lieu of such endorsement(s). PRODUCER CONTACT Amanda Granow NAME: PHONE (970)223-0924 A43 No: (970)267-2231 Colorado HW Insurance Agency, Inc. ADDRESS:amanda.grunow@bankofthewest.com 1075 W Horsetooth Rd, Ste 106 INSURERS) AFFORDING COVERAGE NAICX INSURER A:COlorado CasuaitV Insurance 41785 Fort Collins CO 80526 INSURED INSURER B INSURER C: Fuller Landscaping, LLC INSURER D: 4836 Kiva Drive INSURER E : INSURER F: Laporte CO 80535 COVERAGES CERTIFICATE NUMBER2012-2013 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 REDU CED BY PAID CLAIMS. INSR LTR TYPE OF INSU RANCE ADDL INSR SUBR WVD POLICY NUMBER POLICY EFF MMIDLIYYYY POLICY EXP MMIDDIYYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 COMMERCIAL GENERAL LIABILITY DAME To AG REx PREES Ea occure MISnce $ 100,000 A CLAIMSMADEOCCUR ZBP8617571 6/24/2012 /24/2013 MED EXP(Any one person) $ 15,000 PERSONAL &ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GENL AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000 $ X1 POLICY PRD LOC OMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ BODILY INJURY (Per person) $ ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS H BODILY INJURY(Peraoolderh $ NON OWNED HIRED AUTOS AUTOS PROPERTY DAMAGE Per accident $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DED I I RETENTIONS $ WORKERS COMPENSATION ANDEMPLOYERS'LIABILITY Y/N WC STATUS OTH- TORV LIMITS ER ANY PROPRIETOR/PARTNER/EXECUTIVE❑ E.L. EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED' NIA (Mandatory in NH) E.L. DISEASE EA EMPLOYE $ It yes, describe under DESCRIPTION OF OPERATIONS be ow EL.DISEASE -POLICY LIMIT $ DESCRIPTION OF OPERATIONS / LOCATIONS/ VEHICLES (Attach ACORD 101, Additional Remarks Schedule, it more space is required) Certificate holder is listed as Additional Insured as respects General Liability and their interest in operations of the named insured. CERTIFICATE HOLDER CANCELLATION (970) 221-6707 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Fort Collins ACCORDANCE WITH THE POLICY PROVISIONS. Purchasing Department AUTHORIZED REPRESENTATIVE 215 North Mason PO Box 850 Fort Collins, CO 80522 Amanda Granow ACORD 25 (2010/05) INSn25 r,mmp,, m 01988-2010 ACORD CORPORATION. All rights reserved. Thu ACrlon ,umc and Innn arc runiefurcd mark. of ArnPn Bank of the West 7/23/2012 11:46:15 AM PAGE 1/002 Fax Server DIE500D397A9544 COLORADO- FAX TRANSMITTAL COVER BW INSURANCE .rt AGENCY TO Name City of Fort Collins Company/ Department Voice Phone Fax 919702216707 Phone Date: Monday, July 23, 2012 11:45:54 AM Message: From: Name Matt Diemer Voice 970-267-2226 Phone Fax 86834 Phone Email Matt.Diemer@bankofthewest.com 1075 W Horsetooth Rd. Ste 106 Address Fort Collins CO 80526 Number of pages, including Cover Sheet: 02 This fax is for the personal and exclusive use of the recipient to whom it is addressed. It contains confidential information from the sender. Its contents are to remain absolutely confidential and may also be subject to the attorney -client privilege. If you have received this transmission and are not the intended recipient(s) or his/her agent, please be advised that any disclosure, use, review, copying, selling, dissemination, publication or distribution of this transmission is unauthorized and prohibited. If you have received this transmission in error, please notify the sender immediately by telephone and return the original facsimile to the sender by U.S. Mail. Thank you. Insurance and Investment products are not a deposit or other obligation of, or guaranteed by the bank or its affiliates. Insurance and annuity investments are not insured by the FDIC or any other agency of the U.S., the bank, or any of its affiliates. Insurance and Investment products may lose value. (t 2/05) Bank of the West DIE50OD397A9544 7/23/2012 11:46:15 AM PAGE 2/002 Fax Server A1* Rom CERTIFICATE OF LIABILITY INSURANCE 7/23/2012YY) 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: It the cerlificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. It SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this cerlificate does not confer rights to the cerlificate holder in lieu of such endorsement(s). PRODUCER CONTACT Amanda Granow NAME: PHONE (970)223-0924 A43 No: (970)267-2231 Colorado HW Insurance Agency, Inc. ADDRESS:amanda.grunow@bankofthewest.com 1075 W Horsetooth Rd, Ste 106 INSURERS) AFFORDING COVERAGE NAICX INSURER A:COlorado CasuaitV Insurance 41785 Fort Collins CO 80526 INSURED INSURER B INSURER C: Fuller Landscaping, LLC INSURER D: 4836 Kiva Drive INSURER E : INSURER F: Laporte CO 80535 COVERAGES CERTIFICATE NUMBER2012-2013 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 REDU CED BY PAID CLAIMS. INSR LTR TYPE OF INSU RANCE ADDL INSR SUBR WVD POLICY NUMBER POLICY EFF MMIDLIYYYY POLICY EXP MMIDDIYYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 COMMERCIAL GENERAL LIABILITY DAME To AG REx PREES Ea occure MISnce $ 100,000 A CLAIMSMADEOCCUR ZBP8617571 6/24/2012 /24/2013 MED EXP(Any one person) $ 15,000 PERSONAL &ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GENL AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000 $ X1 POLICY PRD LOC OMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ BODILY INJURY (Per person) $ ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS H BODILY INJURY(Peraoolderh $ NON OWNED HIRED AUTOS AUTOS PROPERTY DAMAGE Per accident $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DED I I RETENTIONS $ WORKERS COMPENSATION ANDEMPLOYERS'LIABILITY Y/N WC STATUS OTH- TORV LIMITS ER ANY PROPRIETOR/PARTNER/EXECUTIVE❑ E.L. EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED' NIA (Mandatory in NH) E.L. DISEASE EA EMPLOYE $ It yes, describe under DESCRIPTION OF OPERATIONS be ow EL.DISEASE -POLICY LIMIT $ DESCRIPTION OF OPERATIONS / LOCATIONS/ VEHICLES (Attach ACORD 101, Additional Remarks Schedule, it more space is required) Certificate holder is listed as Additional Insured as respects General Liability and their interest in operations of the named insured. CERTIFICATE HOLDER CANCELLATION (970) 221-6707 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Fort Collins ACCORDANCE WITH THE POLICY PROVISIONS. Purchasing Department AUTHORIZED REPRESENTATIVE 215 North Mason PO Box 850 Fort Collins, CO 80522 Amanda Granow ACORD 25 (2010/05) INSn25 r,mmp,, m 01988-2010 ACORD CORPORATION. All rights reserved. Thu ACrlon ,umc and Innn arc runiefurcd mark. of ArnPn