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Home My WebLink About503976 DESIGNSCAPES COLORADO - INSURANCE CERTIFICATEDESIG-3 OP ID: LIZ ,A`oRo CERTIFICATE OF LIABILITY INSURANCE DAT10/19DIYYYYI lonsnz 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 303-799-0110 CONTACT NAME: Gail Clark Cherry Creek Ins. Agency, Inc. Suite 500 303-799-0156INC.No 5660 Greenwood Plaza Blvd. Greenwood Village, CO 80111 Y Steven L. Doss �� Q 6 PHONE FAX Est, 720-212-2056 lacNol, 303-799-0156 E-MAIL ADDRESS: GaiIC@thinkccig.com INSURERS AFFORDING COVERAGE NAIC k INSURER A: Westfield Insurance 24112 INSURED Colorado Designscapes,Inc. dba Designscapes Colorado 15440 E Fremont Drive INSURERS: Pinnacol Assurance 41190 INSURER C: Centennial, CO 80112 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 ABBE UBR POLICY NUMBER POLICY EFF MMIDOIYYYY POLICY EXP MM/DO/YYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 A X COMMERCIALGENERALLIABILITY X X CMM5484560 11101/12 11101113 DAMAGE TRENTED PREMISES Ea occurrence $ 300,00 CLAIMS -MADE � OCCUR MED EXP (Any one person) $ 15,00 PERSONAL BADV INJURY $ 1,000,00 X Limited Pollution $1000000/$2000000 GENERAL AGGREGATE S 2,000,00 GEN'L AGGREGATE LIMIT APPLIES PER'. PRODUCTS - COMP/OP AGO S 2,000,00 POLICY X PRO- F LOG I $ AUTOMOBILE LIABILITY A COMBINED SINGLE LIMIT Ea accident)$ 1,D00,D0 BODILY INJURY (Per person) $ A X ANY AUTO X X CMM5484560 11/01112 11/01/13 ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ NON -OWNED HIRED AUTOS RAUTOS X UMBRELLA LIAR X OCCUR EACH OCCURRENCE $ 5,000,00 AGGREGATE $ 5,000,000 A EXCESS LIAB CLAIMS -MADE CMM5484560 11/01112 11/01113 DED I X I RETENTION$ 10000 S B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOMPARTNERIEXECUTIVE VIN OFFICERIMEMBER EXCLUDED? (Mandatory in NH) N I A 4051150 01/01/12 01101/13 TH X TDRV LIMITS _ OER E.L. EACHACCIDENT $ 1,000,00 E.L. DISEASE - EA EMPLOYEE $ 1,000,00 If yea deacrmound, DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT $ 1,000,00 A Leased/Rented Eq CMM5484560 11/01112 11/01/13 Rent/Leas 500,00 A Installation Float CMMS484560 11/01/12 11/01/13 IM Float 100,00 DESCRIPTTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more apace la required) E: 7362 Radiant Neighborhood Park Asc�d by written contract or written agreement, The City of Fort Collins and its officers and employees are included as Additional Insured with Waivers of Subrogation in favor of the Additional Insured, under General Liability and Automobile Liability. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City (.l of Fort Collins THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 300 Laporte Avenue Fort Collins, CO 80522 AUTHORIZED REPRESENTATIVE `�'S"'""'EDJ �'� ACORD 25 (2010/05) @ 1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD