The URL can be used to link to this page

Home My WebLink AboutGENESIS MECHANICAL LLC - INSURANCE CERTIFICATEFAX TRANSMITTAL SHEET ATTN: FROM: City of Fort Collins Flood and Peterson Insurance COMPANY: DATE: 8/14/2012 2:14:34 PM FAX NUMBER: SENDER FAX NUMBER: 2216707 (970)330-1867 # OF PAGES INC. COVER: SENDER PHONE NUMBER: 3 (970) 356-0123 NOTES/COMMENTS: Please see attached documents The contents of this message sent from Flood & Peterson Insurance, Inc. is confidential, possibly privileged, and intended only for its addressee. If you have received this message in error, you must not disclose, copy, circulate, or in any other way use or rely on the information contained in this message. If you have received this message in error, please contact Flood & Peterson Insurance, Inc. by phone at 970-356-0123. Client#: 52109 GENME ACORDTM CERTIFICATE OF LIABILITY INSURANCE oYYY) 8/14/2012 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 and Peterson CONTACTBrianne Danielson NAME: PHONE FAX ac No Ex1 : 970 266-7118 (A/C, No): 970 506-6846 Corporate Mailing Address: P.O. Box 578 Greeley, CO 80632 ADDRIESS. brianne.danielson@floodandpeterson.com PRODUCER GENME CUSTOMER ID#: INSURER(S) AFFORDING COVERAGE NAIC# INSURED INSURER A: The Cincinnati Insurance Co. 10677 Genesis Mechanical, LLC 129 Meadow Lane INSURER B Pinnacol Assurance 41190 Fort Collins, CO 80524 INSURER C 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 LTR TYPE OF INSURANCE %DDI_3LBR NSR NVD POLICY NUMBER POLICY EFF MM/DD/VVVV POLICY EXP MM/DD/VVVV LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMSMADE4OCCUR X PI) Ded:2,500 EPP0153017 7/25/2012 08/01/2013 EACH OCCURRENCE $1,0005000 DAMAGE TO RENTED PREMSES(Ea occurrence) $1005000 MED EXP(Any one person) $105000 PERSONAL a ADV INJURY $150005000 GENERAL AGGREGATE $2,000,000 GENL AGGREGATE LIMIT APPLIES PER POLICY X PIFCT RO LOG PRODUCTS-COMP/OP AGO $2,000,000 $ A AUTOMOBILE LIABILITY ANYAUTO ALL OWNED AUTOS SC HEDU LED AUTOS HIRED AUTOS NONOWNEDAUTOS EPP0153017 7/25/2012 08/01/2013 COMBINED S INGLE LIMIT (Ea accldent) $1000000 X BO DI LV I NJ URV(Per person) $ BO DI LV I NJ URV(Per accident) $ PROPERTY DAMAGE (Per accldent) $ X X $ A X UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMSMADEAGGREGATE EPP0153017 7/25/2012 08/01/2013 EACH OCCURRENCE $150005000 $150005000 DEDUCTIBLE RETENTION 0 $ X $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE 7N OFFICER/MEMBER EXCLUDED? N (Mandatory in NH) 1 yes, describe under DESCRIPTION OF OPERATIONS below WA 4146484 4/01/2012 04/01/201 X T RYLI IT OTH- TORV LIMITS ER EL. EACH ACCIDENT $5005000 E. L. DISEASEEAEMPLOYEE $5005000 I EL.DISEASE -POLICY LIMIT $500,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, it more space is required) City of Fort Collins P.O. Box 580 Fort Collins, CO 80522-0508 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 ACORD 25 (2009/09) 1 of 1 #S725630/M721823 01988-2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD BXD Page This page has been left blank intentionally.