HomeMy WebLinkAbout117224 HORIZON MECHANICAL SOLUTIONS - INSURANCE CERTIFICATEClient#: 44675
rf4111:1a:11
ACORD. CERTIFICATE OF LIABILITY INSURANCE
DATE(MMIDD/YYYY)
03/15/2013
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 endorsement(s).
PRODUCER
CONTACT
NAME: Kelly Beauvais
Flood & Peterson Ins., Inc.
PHONE 970-266-7121 FAI( 970-506-6836
A/C No Est):INC),, No
P. O. Box 578
AIL
ADDRESS: kbeauvais@floodpeterson.com
Greeley, CO 80632
PRODUCER
970 356-0123 '� y
CUSTOMER ID#:
INSURER(S) AFFORDING COVERAGE
NAIC #
INSURED
INSURER A: CNA Insurance Company
Horizon Mechanical Solutions
INSURER B Pinnacol Assurance
Horizon Sheet Metal, Inc
126 Hemlock
INSURER C
Fort Collins, CO 80524
INSURER 0:
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
TYPE OF INSURANCE
DDL
U o
I POLICY NUMBER
POLICY EFF
MWDD/YYYY
POLICY EXP
M/ MDD/YYYY
LIMITS
A
GENERAL LIABILITY
X COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE OCCUR
C5084382042
4/0112013
04/01/2014
EACH OCCURRENCE
$1000000
PREMISES (Ea occurrence)
s2000OO
MED EXP(Any one person)
s15,000
PERSONAL &ADV INJURY
$1,000,000
GENERAL AGGREGATE
$2,000,000
GEN'L AGO RELATE
17 POLICY
LIMIT APPLIES PER:
PRO LOC
PRODUCTS-COMP/OP AGG
$2,000,000
X
$
A
AUTOMOBILE
LIABILITY
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON -OWNED AUTOS
C5084382056
4/01/2013
04101/2014
COMBINED SINGLE LIMIT
(Ea accident)
$1,000,000
X
BODILY INJURY (Per person)
$
BODILY INJURY (Per accident)
$
PROPERTY DAMAGE
(Per accident)
S
1XX
S
A
UMBRELLA LIAB
EXCESS LIAB
OCCUR
CLAIMS-MADE
C5084382073
4/01/2013
04/01/201
EACH OCCURRENCE
$9 000 000
X
X
AGGREGATE
$9 00D 000
DEDUCTIBLE
RETENTION S 10000
$
X
$
B
WORKERS COMPENSATION IN
AND EMPLOYERS' LIABILITY
ANY PROPRIETOWPARTNER/EXECUTIVEY❑
OFFICER/MEMBER EXCLUDED?
(Mandatory in NH)
If yes, describe under
DESCRIPTION OF OPERATIONS below
NIA
4009379
4/07/2013
04/01/201
X WC STA Tu orH
E.L. EACH ACCIDENT
$11000000
E. L. DISEASE - EA EMPLOYEE
$1,000,000
F.L. DISEASE - POLICY LIMIT
$1 000,000
A
Installation
Floater
C5084382042
4/01/2013
r
04/01/2014
$100,000
Ded $1,000
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required)
Certificate holder is named as additional insured.
City of Fort Collins
P O 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.
rnncm:)rrar>t:idssxsaaa_�mr�
ACORD 25 (2009/09) 1 of 1
#S770405/M770395
01988-2009 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD
KLB