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193076 RISK REMOVAL LLC - INSURANCE CERTIFICATE
,acC)R" CERTIFICATE OF LIABILITY INSURANCE DATE IMMIDD YVYV) 9/19/2012 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 endorsements . PRODUCER CONTACT NAME: _ aC._ PHONE, E=t130.3_8.37_8599 jaC NNe)_303=831---5295 E-MAIL s:contractors V IC.COm Van Gilder Insurance Corp. 1515 Wynkoop, Suite 200 Denver CO 80202 INSURERS AFFORDING COVERAGE NAIL# INSURER A:PinnacolA f n O INSURED INSURERB:Westfield Insurance Company0 INSURER C: Morrow Holdings, LLC, dba Risk Removal, LLC. 1925 Timberline Rd, Office I INSURER D: Fort Collins CO 80525 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 1977603839 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 INSURANCE ADDL SUBR POLICY EFF POLICY EXP LTR INSR WVD POLICY NUMBER MMIDOM'W MM/DO/YYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR DAMAGE TO RENTED PREMISES Ea ottunence MED EXP (Any one person) $ $ PERSONAL BADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ F]POLICY [ PRO LOG $ B OMOBILE LIABILITY Y Y CWPI106145 10/1/2012 0/1/2013 Ea accident $1,000,000 %( BODILY INJURY (Per person) $ ANYAUTO ALL Oi� SCHEDULED AUUTOSS AUTOS BODILY INJURY (Per accident) $ 'X Perr ac DentDAMAGE $ IIN. _I HIRED AUTX AUUTOSWNED OB $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS ILIA B CLAIMS -MADE DEO I RETENTION $ $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N Y d063346 �10/1/2012 10/1/2013 X WC STATU- OTH- TORV LIMITS R E.L. EACH ACCIDENT $1,000,000 ANY PROPRIETORIPARTNEWEXECUTIVE OFFICERIMEMBER EXCLUDED? Y❑ NIA �� E.L. DISEASE E-EA EMPLOYE $1,000.000 (Mandatory in NH) If yea. describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT 1 $1,000,000 B Physical Damage: �CWP7306345 110/1/2012 �10/1/2013 Comp Deductible $1000 ACV Comprehensive 8 Collision Deductible $1000 Collision DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) Kenyon Morrow is excluded from Workers Compensation Re: Water Utilities, 700 Wood Street, Fort Collins, CO City of Fort Collins Purchasing PO Box 580 Fort Collins CO 80522-0580 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 © 1988.2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD