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HomeMy WebLinkAbout113664 JORDAN'S TREE MOVING & MAINTENANCE INC - INSURANCE CERTIFICATE (3)OP ID: SC A�CO�ROA CERTIFICATE OF LIABILITY INSURANCE OAT12/19DYYYY) 12/19/12 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 970-223-1804 CONTACT .— NAME: Front Range Insurance Group _ . 1100 Halton Drive Suite 100-INC, Fort Collins, CO 80525 David A. Wooldridge LUTCFAAI ,. PHONE _. .FAX - - No EXt: . AIC, No: E-MAIL PRODUCER - CUSTOMER Ion:JORDA-2 INSURERS AFFORDING COVERAGE NAIC k INSURED Jordan'a Tree INSURERA: Secura Insurance Companies 22543 Moving & Maintenance, Inc INSURER B: Pinnacol Assurance 41190 1025 Smithfield Drive Fort Collins, CO 80524 INSURERC: INSURER D : NSURER 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 TR TYPE OF INSURANCE ADDL SUER POLICY NUMBER MM POLICY DD/YYYYI IMMIDDNYYYI LIMITS A A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY _11CLAIMS-MADE [XI OCCUR X Prof Liability X CP3200287 CP3200287 - 12119/12 12119/13 EACH OCCURRENCE $ 1,000,00 PREMISES Ea occurrence) $ 300,00 MED EXP (Any one person) $ 10,00 PERSONAL & ADV INJURY $ 1,000,00 GENERAL AGGREGATE $ 2,000,00 GEN'L AGGREGATE LIMIT APPLIES PER X POLICY r7 PRO- JECTLOC PRODUCTS - COMP/OP AGG $ 2,000,00 lProf Liab $ 1,000,00 A AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON-OWNEDAUTOS CA3200288 CA3200288 CA3200288 12119112 12119112 12/19/12 12119/13 12/19/13 12119/13 COMBINED SINGLE LIMIT $ 1,000,00 X BODILY INJURY BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ X X $ $ UMBRELLA LIAR EXCESS LIAB OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DEDUCTIBLE RETENTION $ $ $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE YIN OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS be. NIA 4040726 I 03110112 03110113 X WC STATU- OTH- E.L. EACH ACCIDENT $ 1,000,00 E.L. DISEASE - EA EMPLOYEE $ 1,000,00 E.L. DISEASE -POLICY LIMIT I $ 1,000.00 A Equipment Floater 12119/12 12/19/13 Leased 250,00 Ded 50 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space is required) Holder is listed as Additional Insured with regards to General Liability. Project: Mason Corridor Tree Transplanting CITY OF City of Fort Collins 215 N. Mason Street, 3rd FL 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 ©1988.2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009109) The ACORD name and logo are registered marks of ACORD