HomeMy WebLinkAbout353790 AMERICAN AIR HEATING & AIR CONDITIONING INC - INSURANCE CERTIFICATE (5)OP ID: SA
'4`� CERTIFICATE OF LIABILITY INSURANCE
DAT04/05DYYYY)
04/05/13
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 303-740 8101
Jewell Insurance Associates 303-740-8019
8480 E. Orchard Road, Ste 5500
Greenwood Village, CO 80111
David P. Jewell, C.I.C.
l^
LJ, I
CONTACT
NAME: Susan Salazar
ac° No E.t:303-740-8101 FAx
ac No: 303-496-1009
AND AIL
ADRESS: susans@jjia.com
PRODUCER
CUST M ER IO p: AMERAIR
INSURERS AFFORDING COVERAGE
NAIC p
INSURED American Air Heating & Air
INSURER A:Atain Specialty Ins.Co.
Conditioning, Inc.
INSURERB:Auto-Owners Insurance
18988
561 Garden Dr., Unit F
Windsor, CO 80550
INSURER C: Pinnacol Assurance
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
LTR
rypE OF INSURANCE
A
POLICY NUMBER
POLICY EFF
MMIDD/YYYY)
POLICY EXP
(MMIDDNYYYI
LIMITS
A
GENERAL LIABILITY
X COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE a OCCUR
X
CIP143826
04/01/13
04/01/14
EACH OCCURRENCE
$ 1,000,00
RENT
PREMISES Eaaccunence
8 100,000
MED EXP (Any one Person)
$ 5,00
PERSONAL B ADV INJURY
$ 1,000,00
GENERAL AGGREGATE
$ 2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER
X POLICY PRO-LOC
PRODUCTS - COMP/OP AGG
$ 2,000,00
$
B
AUTOMOBILE
LIABILITY
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON -OWNED AUTOS
4500151000
04/01/13
04101114
COMBINED SINGLE LIMIT
(Ea accident)
$ 1,000,000
BODILY INJURY (Per person)
$
BODILY INJURY (Per accident)
$
X
PROPERTYGE
(Per accident)
itlent)
$
X
X
$
UMBRELLA LIAB
EXCESS LIAB
OCCUR
CLAIMS -MADE
EACH OCCURRENCE
$
AGGREGATE
$
DEDUCTIBLE
RETENTION $
g
$
C
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY
OFFICER/MEMBOEREXCLUORIE ECUTIVE Y/❑N
(Mandatory in NH)
If yes, describe under
DESCRIPTION OF OPERATIONS below
NIA
_r
4050189
10/01/12
10/01/13
X WC STATU- OTH-
E.L. EACH ACCIDENT
$ 500,000
E.L. DISEASE - EA EMPLOYEE
$ 500,000
E.L. DISEASE -POLICY LIMIT
$ 500,00
B
B
Property Section
Equipment
7400151011
7400151011
04/01/13 1
04101/13 1
04101114 IContent
04101114
172,26
Tools 5,000
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Addlllonal Remarks Schedule, If mare space Is required)
Fort Collins Utilities are included as additional insured with respects to
the general liability coverage.
FFFFFFF
Fort Collins Utilities
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.
AUTHORIZED REPRESENTATIVE
1998-2009 ACORD CORPORATION. All rights reserved.
ACORD 25 (2009/09) The ACORD name and logo are registered marks of ACORD