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HomeMy WebLinkAbout120528 FORT COLLINS TREE CARE INC - INSURANCE CERTIFICATE (4)CERTIFICATE OF LIABILITY INSURANCE DATE (MWDD 1 3/6/2013 YY1 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. •I 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' I_ I'^. �% First t`tairis_treet Insurance LLC - r 275 S. Main Street, Suite 100 P. O. BOX 847 _ Longmont" CO 80502 CONTACT NAME:_ Pat Deaver PHONE FAX , (303) 776-5122 - '- % _ (Bo31n5-sags • ' ` _(AID, No, ExtP. �-(AIC„No){ E-MAIL s: pdeaver@firstmainstreettcom-ADDRE- PRODUCER 0001410E IDp:. ' _CUSTOMER INSURER(S)AFFORDING COVERAGE _ NAIC If _ INSURED ks-l� Fort Collins Tree Care, Inc 301 East Douglas Road Fort Collins CO 80524 INSURER A:HartfOrd Fire Insurance Co _:19682 INSURER B:Pinnacol Assurance I INSURER C: _ INSURER O: INSURER E: WSURERF: ' COVERAGES CERTIFICATE NUMB'e R:13--14 GL. AL INCREVISION 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 BY PAID CLAIMS. `REDUCED VTR TYPE OF INSURANCE IIIN BIWVR POLICY NUMBER MM DID YVV MMLDO/YYYY LIMITS I GENERAL LIABILITY LEACH OCCURRENCE I $ 1,000,000 A X, �_ �_ 1 CLAIMS -MADE OCCUR 34UUNSR3900 �3/5/2013 3/5/2014 DAMAGE YO RENTED-1 ME❑ EXP (Any one personl_J $ 300,000 $_ 1.021000 (PERSONAL B AOV INJURY 1$ 1,000,000 "- GENER_AE AGGREGATE Is 2,000,000 r GATE LIMIT APPLIES PER GENL AGGREGATE I$ "'2, 000, 000 I�X ! POLICY _ PRO 1-7 LOC IFCT _ _` _ _PRODUCTS-COMPIOP.AGG - - is - A AUTOMOBILE LIABILITY- X ANY AUTO - I ALL OWNED AUTOS '34UUNSR3900 3/5/2013 3/5/2014 COMBINED SINGLE LIMIT (Ea accidenp .. 1, 000 IS '000 _ (BODILY INJURY (Per person) $ .. BODILY INJURY (Per accident) �$ J SCHEDULED AUTOS HIRED AUTOS X NON -OWNED AUTOS IPROPERTY DAMAGE 1 (Per accident) I$ Uninsured motorist Medical payments BI-single $ UMBRELLA LAB E%CESS LIAB OCCUR CLAIMS -MADE I EACH OCCURRENCE $ AGGREGATE $ —� DEDUCTIBLE L_ is i I ' , ! RETENIION $ I ! B 'I WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANV PROPRIETOR/PARTNERIEXECUTI VE Y❑ OFFICERIMEMBER EXCLUDED9 (MandatoryinNH) I INIAI 4148327 05/01/2013 �05/01/2014 I y� WCSTATITS I '�R-_v-_. —- I E.L. EACH ACCIDENT 1 $ 100,000 —— LEI . DISEASEEAEMPLOYEE_$ 100,000 If yes, describe under DESCRIPTION OF OPERATIONS below I _ E.L. DISEASE - POLICY LIMIT 1 $ 500,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) City of Fort Collins as Additional Insured as required by written contract per General Liability policy fox.. CERTIFICATE HOLDER CANCELLATION (970) 221-6707 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. Purchasing Division P O BOX 580 AUTHORIZED REPRESENTATIVE Fort Collins, CO 80522 Pat Deaver/PAT /24.f i) "— ACORD 25 (2009109) ©1988-2009 ACORD CORPORATION. All rights reserved. INS025 (200909) The ACORD name and logo are registered marks of ACORD