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HomeMy WebLinkAbout196580 L & L LANDSCAPE (LRD INC) - INSURANCE CERTIFICATE (6)11/01/2012 TH 15:28 FAX 970 674 8826 Renaissance Ins, Group
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OP ID: MM
'`# a CERTIFICATE OF LIABILITY INSURANCE aT11101 orcrrY)
11101/12
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 pellcy(ies) must be endorsed. If SUBROGATION IS WAIVED, Subject to
the terms and conditions of the policy, certain policies may require an endomement. A statement on this certificate does not confer rights to the
certificate holder in lied of Such endomement(s).
=UCER Phone:
maissdnce Insurance Group Fax:
O Box 478
11 E Main Street
'indsor, CO 60550
INSURED
DBA L & L Landscape
PO Box 62
Windsor, CO $0550-0062
W SURERIS) AFFORDMG COVERAGE
A -Allied Insurance Company
a: Pinnacol Assurance
rnVFRA11FA rFrdTIFIr ATF NI IMRFR• vevlainM an IkAGFG.
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 APFORDED BY THE POLICIES DESOmREO HEREIN IS SU&IECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
_
ILTR TYPE OF INSVRRNCE �aoaaD POLICY NUMBER MNIODNVYY POw0urYYY LIMITS
A
GENERALMBIUTY
X
CONAIERCUIL GENERAL LIABILITY
CLAIMS -MADE n OCCUR
ACPMTC07515036564
04/20192
04I20113
EACH OCCURRENCE
3 11000,00
$ 100,00
PREMISES(Ea IXCnRanae)
WDEXP(Awwomwn)
$ 10,00
PERSONAL4ADVINJURY
Is _ 1r000A0
GENERAL AGGREGATE
$ 2,000,00
GEN'L AGGREGATE UMITAPPLIE$ PER:
PRODUCTS-COMP/OPAGG
$ 2.000.00
POLICY F7 PRa LOC
_
S
A
AUTOMOBILE LIABRfry
X , ANYAUrO
I
COMBINED SINGLE LIMIT
(Ea aadem)
S 500.00
BODILY INJURY(Per pereenJ
$
ALL OWNEDAUTOS
SCHEDULEOAUT06
X XIRED AUTOS
CP8A7515036564
04120/72
04/20/13
BODILY INJURY (Peramdent)
$
-
$
PROPERTrOAMAGE
(Pa arzidad)
X NON-OMEDAUTOS
-
-
S
UMBRELLA Me
OCCUR
EACH OCCURRENCE
E _
IXDES9 MB
CLAIMSi E
N/A
DEDUCTIBLE
..
S
_
S
RETENTION S
NSA
AND
OTH-
X-
C
EMPLOYERS YIN
ANYPROPRIETORRMTNEIUE(ECDDVE
OFDCERMEMSER EXCLUDED?
(Mantlamry in NH)
IfW5 describe under
DESCRIPTON OF OPERATIONS Oeknv
NIA
4032168
08/01112
I
09101/13
TO. 2Y1Rd
1 EL EACH ACCIDENT
§ _ 1,000,00
$ 1,000.00
$ 1,000,00
E.L DISEASE • EA EMPLOYEE
E. L. DISEASE,-POLICYLIMn
A
Laasod/Rentad
CPCIM7615016564
G5125f12
04/20/13
Special 65,00
Equipment
Perils $500 de
DESCRIPTION OF OPERANONS/ LOCATIONS/ VEHICLES (Attach ACORP 101, A,JcUlo Ml Ramarks SchedWq If mmM apace le rac d a )
Fax: 221-6707
r FRTIFIr ATF mn1 nFR PAMrFI I ATlnkt
CITY OF
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
City of Fort Collins
ACCORDANCE WITH THE POLICY PROVISIONS.
PO Box 580
AUTHORIZED REPRESENTATNE
Fort Collins, CO 80522
I
Lap �'�`^""'Y^L `
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ACORD 26 (2009109) The ACORD name and logo are registered marks of ACORD