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Home My WebLink About129302 HAGEMAN EARTH CYCLE INC - INSURANCE CERTIFICATE (4)Client#: 24703 HAGEA ACORD. CERTIFICATE OF LIABILITY INSURANCE DATE(MAVDOII'1'YY) 11/28/2012 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 (� 0 CONTACT NAME: Kelly Beauvais PHONE 970 266-7121 970 506-6846 AIC No Eat : A/C, No E..R kbeauvais@floodpeterson.com ADDRESS: CUSTOM ER ID N: INSURER(S)AFFORDING COVERAGE NAIC0 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 PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR 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 LIEL TYpE OFINSURANCE ODL UBR POLICY NUMBER POLICY EFF MMIDDIY POLICY EXP MMIDDIYYYY LIMITS • GENERALDABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE N OCCUR X PD Ded:500 CWP234489330 12/01/2012 12/01/2013 EACH OCCURRENCE $1 000000 PREMISES(Edoccurrence) S100,000 MEDEXP(Anyoneperan) $5,000 PERSONAL B ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE 1-1 POLICY LIMIT APPLIES PER: PRO- LOC PRODUCTS - COMP/OP AGG s2,000,000 $ A AUTOMOBILE LIABILITY ANY AUTO ALLOWNEDAUTOS SCHEDULED AUTOS HIRED AUTOS NON OWNED AUTOS CWP234489330 12101/2512 12101/2013 COMBINED SINGLE LIMIT (Ea accident) $1000000 X BODILY INJURY(Por person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ X X S A GMEIRNSILALIAB CLIAB X OCCURSINDERCU236140830 CLAIMS -MADE 2/0112012 12/01/201 EACH OCCURRENCE $2000,000 [�X AGGREGATE $2 00O 000 EDTIBLE RETEHON S $ $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY IN ANY OFFICERIMEMBEEREXCLUDED?ECUTIVEY❑ (Mandatory In NH) It yes, describe under DESCRIPTION OF OPERATIONS below NIA 4036218 10101/2012 10/01/201 X T BTATU OTH- EL EACH ACCIDENT $100,000 E.L. DISEASE -EA EMPLOYEE $100,000 E L. DISEASE -POLICY LIMIT $500 000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more apace is repuited) City of Fort Collins SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Risk Management Dept. THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 9 P ACCORDANCE WITH THE POLICY PROVISIONS. Attn: Darlene P.O. Box 580 AUTHORIZED REPRESENTATIVE Ft Collins . CO 80522 11988.2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009109) 1 of 1 The ACORD name and logo are registered marks of ACORD #S7483081M748294 I HAGEA Client#: 24703 ACORD.. CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY) 11/28/2012 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 970 356.0123 CONTACT NAME: Kelly Beauvais PHONE 970 266.7121 970 506.6846 AIC No Ext : AIC, No Be kbeauvais Iood eterson.com AODREss: P PRODUCER — CUSTOMER ID#: INSURER(S) AFFORDING COVERAGE NAIL # INSURED Hageman Earth Cycle, Inc. 3501 E. Prospect Road Fort Collins, CO 80525 INSURERA: Continental Western Group INSURER BPinnacol Assurance INSURER C INSURER D INSURER E: INSURER F : I COVERAGES CERTIFICATE NUMBER: IREVISION 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 CONTRACTOR OTHER DOCUMENT W ITH 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. INSR TYPE OF INSURANCE ODL UBR POLICY NUMBER MMIDOIYFYYY MM%ODIEYXYYY LIMIT HE A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR X PD Ded:500 CWP234489330 2/0112012 12/01/201 EACH OCCURRENCE -DAMAGE 10 HEN IPREMISESEaocccurence MED EXP(Any one person) PERSONAL B ADV INJURY S,, GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER 17 POLICY PRU F-I LOG PRODUCTS-COMPIOP AGG s2,000,000 $ A AUTOMOBILE LIABILITY ANV AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS AUTOS CWP234489330 2/01/2012 12/0112013 COMBINED SINGLE LIMIT (Es aecitlenl) $1 000 000 BODILY INJURY(Per Person) S BODILY INJURY(Per accident) S 1XX PROPERTY DAMAGE (Par accident)NON-OWNED $ A X UMBRELLALLIB EXCESS LIAB X OCCUR CLAIMS -MADE BINDERCU236140830 2/01/2012 12/01/201 EACH OCCURRENCE 52000000 AGGREGATE s2,000,000 DEDUCTIBLE RETENTION S$ $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETORIPARTNERIEXECUTNE Y❑ OFFICERIMEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below NIA 4036218 10/01/2012 10101/201 % WCSTATU- OTH- ER E.L. EACH ACCIDENT $100,000 E.L. DISEASEEAEMPLOYEE $100, 000 E.L.DISEASE-POLICY LIMIT s500000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If mom 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 ACORD CORPORATION. All dolts reserved ACORD 25 (2009109) 1 of 1 The ACORD name and logo are registered marks of ACORD #S748304/M748294 KLB