HomeMy WebLinkAbout102136 KORBY LANDSCAPE LLC - INSURANCE CERTIFICATE (11)04-09-13;10:059M; ;303-745-0544 # 1/ 1
CERTIFICATE OF LIABILITY INSURANCE IGIQ1�nl
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 pollcy(les) 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 endomemenl(s).
PRODUCER
ALESSANDRA INSURANCE AGENCY
3100 S Parker Rd #100
Aurora, CO 80014
LUNIAGI
NAME:
PHONE FAX
Arc Ne E : Arc No:(303) 745-0544
ADDRESS:ralessandra@farmersagent.com
mellflEfle DIN (I AFF Ofl 0 COWRACE
WJDY
INSURER A
INSURED Korlby Landscape LLC
Korby Landscape LLC
3201 E Mulberry St Unit S
Fort Collins, CO 80524
INSURER B: Farmers Insurance Group
INSURER C:
INSURER D:
INSURERE:
INSURER F:
1r1VFRAC,FS CFRTIFIr:ATF MI IAARFR• RPVICInnI en IaAPC.R-
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 REOUIREMENT, 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.
LTA
TYPE OF INSURANCE
INSR
wIm
POLICY NUMBER
M D
M
LIMITS
A
GENERAL LIABILITY
COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE Fx� OCCUR
604863001
11/10/2012
11/10/2013
EACH OCCURRENCE
$
PREMISES Ea attunence
$
MED EXP (Any one person
$ r Ann
PERSONALAADVINJURY
$ j
GENERAL AGGREGATE
$ 2,000,000
GENL AGGREGATE LIMIT APPLIES PER:
POLICY 7 PEA LOC
PRODUCTS - COMP/OP AGO
S 2,A00,000
$
A
AUTOMOBILE
LIABILITY
ANYAUTO
ALL OWNED SCHEDULED
AUTOS AUTOS
HIRED AUTOS AUTOSWNED
604863001
11/10/2012
11/30/2013
Bs occident
$ 1,000,000
BODILY INJURY (Per person)
S
BODILY INJURY ltl
eaccident)
( )
$
(Par c l n
S
S
A
UMBRELLA LIAB
EXCESS LIAR
OCCUR
CLAIMS -MADE
604863444
11/10/2012
11/30/2013
EACH OCCURRENCE
S 1 00O 000
AGGREGATE
$ 1,000,000
DED 1317 1 REfENTON $
$
B
WORKERS COMPENSATION
AND EMPLOYERS• LIABILITY YIN
M PRWffl flT EHIEXSCOMI
DFFICERIMEMBER EXCLUDED? ❑
Pu�•es�mmrp n NN)
IDESERIPTION OF OPERATIONS below
NIA
A04171131
02/23/2013
02/21/2014
I WCSTATU• I OTH-
TORY Umas
111 EACH ACCIDENT
$ 100,000
E.L. DISFA SE • EA EMPLOYE
S 100,000
EL DISEASE • POLICY LIMIT
I y 500 , D OO
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Rennama Schedule• it more space Is mgalred)
r:FRTIFICATC wni DFR r`Anlr`CI I ATInNI
City
of Fort Collins
PO BOX
580
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF. NOTICE WILL BE DELIVERED IN
Fort
Collins, CO 80525-0580
ACCORDANCE WITH THE POLICY PROVISIONS.
Fax:
(970)221-6707
AUTHORIZED REPRESENTAT'TW
I /�J /Jy%�- y/�/ysI "'•v�•••-,-..
01988-2010 ACORD CORPORATION. Al rights reserved.
ACORD25(2010/05) The ACORD name and logo are registered marks of ACORD