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102525 ALLEN PLUMBING & HEATING INC - INSURANCE CERTIFICATE (3)
UP It): KC ,acoRO CERTIFICATE OF LIABILITY INSURANCE `.� D02/27/201ATE YY) 02/27/2013 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 Phone: 970-635-9400 CONTACT PFS Insurance Group -JT 4848 Thompson Pkwy, Ste 200 Fax: 970-635-9401 Johnstown, CO 80534 Dave Janssen PHONE FAX ac Na Ext : A/C No): E-MAIL ADDRESS: PRODUCER CUSTOMER IALLEN-4 D#: INSURER(S) AFFORDING COVERAGE NAIC# V, INSURED Allen Plumbing & Heating Inc. INSURER A: EMC Insurance Companies 121415 & Allen Plumbing & Mechanical INSURER B: Pinnacol Assurance 141190 & Allen Service 101 S. Link Lane INSURER C: Fort Collins, CO 80524 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 ADDLTSUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE I POLICY NUMBER MMIDDIYYYY MMIDDIYYYY LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR X Blanket Addl Ins 4X69971 03/01/2013 03/01/2014 EACH OCCURRENCE DAMAGE TO RENTED PREMISES {Ea occurrence) $ 1,000,000 $ 300,000 MED EXP(Any one person) $ 10,000 PERSONAL &ADV INJURY $ 1,000,000 X Blanket Waiver GENERAL AGGREGATE S 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER'. POLICY FX PRO n LOG PRODUCTS - COMPIOP AGG $ 2,000,000 $ A AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIREDAUTOS NON -OWNED AUTOS Blanket Al/Waiver 4X69971 03/01/2013 03/01/2014 COMBINED SINGLE LIMIT (Ea accident $ 1,000,000 X BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ X X $ X S A UMBRELLA LAB E%LESSLIAB X OCCUR CLAIMS -MADE 4X69971 03/01/2013 03/01/2014 EACH OCCURRENCE $ 5,000,00 X AGGREGATE $ 5,000,000 DEDUCTIBLE RETENTION $ 10,00I $ X $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANV PROPRIETOR/PARTNER/EXECUTIVE YIN (Mandatory In ER EXCLUDED? Ify s, (Mandatory In NH) Dyes, describe under DESCRIPTION OF OPERATIONS below NIA' 4049622 BLANKET WAVER OF SUBRO 07/01/2012 07/01/2013 WC STATU- I IIOTH- X wcY_ AT8I L_N EL EACH ACCIDENT $ 1,000,000 EL DISEASE - EAEMPLOVEEg 1,000,000 E.L. DISEASE -POLICY LIMIT 1 $ 1,000,000 A (Equipment -Leased 4X69971 03/01/2013 03/10/2014 (Lim t 100,000 Ded DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) CITYOFC City of Fort Collins PO Box 580 Fort Collins, CO 805236 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 A ©1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009/09) The ACORD name and logo are registered marks of ACORD