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Home My WebLink About129302 HAGEMAN EARTH CYCLE INC - INSURANCE CERTIFICATE (2)Client#: 24703 HAGEA ACORD. CERTIFICATE OF LIABILITY INSURANCE F DATE(MMMD/YYYY) O9/07/2012 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: Kelly Beauvais Flood & Peterson Ins., Inc. PHONE g70-266-7121 A 970-506-6845 A/C No Eid: AIC, No: P. O. Box 578 E-MAIL ADDRESS: Kelly.BeauvaiS@floodandpeterson.com BeauvaiS@floodand eterson.com Greeley, CO 80632 PRODUCER 970 356-0123 h CUSTOMR ID N: INSURER(S) AFFORDING COVERAGE NAIL a INSURED INSURER A: Continental Western Group Hageman Earth Cycle, Inc. Pinnacol Assurance 3501 E. Prospect Road INSURER B: Fort Collins, CO 80525 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 LTIL TYPE OF INSURANCE NODE UBRI POLICY NUMBER POLICY EFF MWDD/YYYY POLICY EXP MM/DDNYYY LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL ABILITY FvI CLAIMS MADE OCCUR X PO Ded:500 CWP234489330 12/01/2011 12/01/201 EACH OCCURRENCE $1000000 TO RENTED PREMISES Ea occurrence) $1DAMAGE 00000 MEO EXP (Any one person) $5,000 PERSONAL &ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE POLICY LIMIT APPLIES PER: x PROJeCT LOC PRODUCTS - COMP/OP AGG s2,000,000 $ A AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS CWP234489330 12/01/2011 12101/2012 COMBINED SINGLE LIMIT (Ea accitlent) $1000000 BODILY INJURY(Per person) $ BODILY INJURY(Per accitlent) $ JX PROPERTY DAMAGE (Per accitlent) $ $ A I XI UMBRELLA Line EXCESS LIAR X OCCUR CIAIMS-MADE CU236140830 12/01/2011 12/01/201 EACHOCCURRENCE $2 OOO 000 171 AGGREGATE s2,000,000 DEDUCTIBLE RETENTION S $ S B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETORIPARTNER/EXECUTIVE YIN OFFICEWMEMBER EXCLUDED? (Marauder, in NH) If yes, describe under DESCRIPTION OF OPERATIONS below WA 4036218 10/01/2012 10/01/201 `r+c STATU- OTH- E.L. EACH ACCIDENT $100000 E.L. DISEASE -EA EMPLOYEE $100,000 E.L. DISEASE -POLICY LIMIT $500000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, H more space is required) City of Fort Collins Risk Management Dept. Attn: Darlene P.O. Box 580 Ft Collins , CO 80522 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 01988-2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009/09) 1 of 1 #S730831/M730825 The ACORD name and logo are registered marks of ACORD SXF HAGEA Client#: 24703 ACORDIn CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY) F 09/07/2012 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 & Peterson Ins., Inc. P. O. Box 578 Greeley, CO 80632 970356-0123 CONTACT NAME: Kelly Beauvais PaHcONEo FAX , g70-266-7121 No : 970-506-6845NEs: ADDRESS: KeIIy.Beauvais@floodandpeterson.com PRODUCER CUSTOMER ID Y: INSURERS) AFFORDING COVERAGE NAICs INSURED Hageman Earth Cycle, Inc. 3501 E. Prospect Road Fort Collins, CO 80525 INSURER A: Continental Western Group INSURERS: Pinnacol Assurance 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 INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHIC CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TE EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. L R TYPE OF INSURANCE kDDLIEL MIL 0112— UBR POLICY NUMBER MM/DDNYYV MM/DD/YYYV LIMIT id A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY OCCUR X PD Ded:500 I CWP234489330 I 12/01/2011 12/01/201 EACH OCCURRENCE DAMAGE TT -RENTED PREMISES Ea occurrence)CLAIMS-MADE MED EXP(Any one person) PERSONAL&ADV INJURY $,, GENERAL AGGREGATE s2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: 1-7 POLICY X PRO 7 LOC PRODUCTS - COMP/OP AGO $2,000,000 I S A AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NONOWNED AUTOS CWP234489330 12/01/2011 - 12/01/2012 COMBINED SINGLE LIMIT (Ea aaldent) $1000000 X BODILY INJURY (Per person) $ BODILY INJURY (Per accident) IS PROPERTY DAMAGE (Peraccidenl) $ X X $ A X UMBRELLA LIAR X EXCESS UAB OCCUR CLAIMS -MADE CU236140830 12/01/2011 12/01/201 EACH OCCURRENCE s2,000,000 AGGREGATE s2,000,000 DEDUCTIBLE RETENTION $ $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVEYQ OFFICER/MEMBER EXCLUDED? (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below N/A 4036218 10/01/2012 10/01/201 WC STATU- OTH- E.L. EACH ACCIDENT $100000 E.L. DISEASE CA EMPLOYEE $100,000 E.L. DISEASE -POLICY LIMIT s500OOO DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) Re: Snow Removal City of Fort Collins Purchasing Department 215 N Mason PO Box 580 Fort Collins, CO 80522 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE 01988-2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009/09) 1 of 1 #S730830/M730825 The ACORD name and logo are registered marks of ACORD SXF Client#: 24703 HAGEA ACORD. CERTIFICATE OF LIABILITY INSURANCE DATE/YYVY) 09/07/207/2012 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER($), 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 & Peterson Ins., Inc. P. O. Box 578 Greeley, CO 80632 970356-0123 CONTACT NAME: Kelly Beauvais PHONE g70-266-7121 FAX g70-506-6845 A/C No Ext : AIC, No ADDRESS: Kelly.Beauvais@floodandpeterson.com PRODUCER CUSTOMER to INSURER(5) AFFORDING COVERAGE NAICk INSURED Hageman Earth Cycle, Inc. 3501 E. Prospect Road Fort Collins, CO 80525 INSURER A: Continental Western Group INSURER BPinnacol Assurance 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 TYPE OF INSURANCEMJL NDoL UBR POLICY NUMBER POLICY EFF MM/DDNYYY POLICY EXP MWDDNYYY LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR X PD Ded:500 CWP234489330 12/01/2011 12101/2012 EACH OCCURRENCE $1000000 DAMAGE TO RENTED PREMISES Ea occurrence) $100000 MED EXP(Any one person) $5,000 PERSONAL &ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE 17 POLICY LIMIT APPLIES PER: X PRO- n LOC IFQT PRODUCTS - COMP/OP AGG $2,000,000 $ A AUTOMOBILE LIABILITY ANV AUTO ALL OWNED AUTOSRODILV SCHEDULED AUTOS AUTOS NON -OWNED AUTOS CWP234489330 12/01/2011 12/01/2012 COMBINED SINGLE LIMIT (Ea accident)$1000000 BODILY INJURY (Per person) $ INJURY (Per accident) $ 1XX PROPERTY DAMAGEHIRED (Per accident$ $ $ A X UMBRELLA LIAB EXCESS LIAR X OCCUR CLAIMS MADE CU236140830 12/01/2011 12/01/201 EACH OCCURRENCE s2,000,000 AGGREGATE $2 000 000 DEDUCTIBLE RETENTION $ $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITYMlq ANY PROPRIETOFVPARTNERrEXECUTIVE Y/N OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If OE SC describe RIPTION OF OPERATIONS below N/A 4036218 10/01/2012 10/01/2013 WCSTATU- OTH- E.L. EACH ACCIDENT $100,000 E.L. DISEASE - EA EMPLOYEE $100,0oo E.L. DISEASE-er POLICY LIMIT $500000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attack ACORD 101, Additional Remarks Schedule, K more space is required) City of Fort Collins Risk Management Dept. Attn: Darlene P.O. Box 580 Ft Collins . CO 80522 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 01988-2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009/09) 1 of 1 #S730831/M730825 The ACORD name and logo are registered marks of ACORD SXF