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HomeMy WebLinkAbout165318 CMS MECHANICAL SERVICES INC - INSURANCE CERTIFICATE (4)CMSME-1 OP ID: JD '4f� CERTIFICATE OF LIABILITY INSURANCE DATE( /23/1v v) 04/23/13 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 endorsement(s). PRODUCER Phone: 970-482-7747 Brown & Brown Inc 4532 Boardwalk Dr, Suite 200 Fax: 970-484-4165 Fort Collins, CO 80525 Sharma M Jamsay CONTACT NAME: LAIC o E.M E-MAIL ADDRESS: INSURERIS) AFFORDING COVERAGE NNC N INSURER AWestfield tfield Insurance Company 24112 INSURED CMS Mechanical Services, Inc., INSURER B: Pinnacol Assurance Company 41190 609 Technology Circle, Suite A Windsor, CO 80550 INSURER C 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 TYPE OF INSURANCE �roL BR POLICY NU MBER POLICY EFF MMIDDNYYY POLICY EXP MMIDDNYYY LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE I OCCUR TRA6047660 04127/13 04127/14 EACH OCCURRENCE DAMAZETORENTE PREMISES Ea occurrence $ 1,000,000 $ 300,000 MED EXP(My one person) $ 10,000 PERSONAL& ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY A PRO- LOC PRODUCTS - COMP/OP AGG $ 2,000,000 $ A AUTOMOBILE LIABILITY ANY AUTO AOSCHEDULED AUTOS IHI AU TOS NON-0WNED HIRED AUTOS AUTOS TRA6047660 04127/13 04127114 COMBINED SINGLE LIMIT Ea auitlenl $ 1,000,000 X BODILY INJURY(Per person) $ BODILY INJURY (Per accitlenD $ PROPERTY DAMAGE Per accitlent $ $ A X UMBRELLA LIAR EXCESSLIAB X OCCUR CLAIMS -MACE TRA6047660 04127113 04/27/14 EACH OCCU RRENCE $ 2,000,000 AGGREGATE $ 2,000,000 DED X RETENTION$ 0 $ B AND EMPLOYERS' LIABILITY WORKERS COMPENSATIONIE ANY PROPRIETORIPARTNERXECUTIVEY� OFFICERIMEMBER EXCLUDED? (Mandatory in NH) Had escriba under DRIPTION OF OPERATIONS below NIA 4105092 06/01/13 06/01114 11- X TARY LIMIT TR E.L.EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYE $ 1,000,000 EL. DISEASE -POLICY LIMIT 1 $ 1,000,000 DESCRIPTION OF OPERATIONS/ LOCATIONS I VEHICLES (Attach ACORD 101, AEJINonal Remarks Umdule, N more space Is required) See Notes CITYFT5 City of Fort Collins Purchasing P. O. Box 580 Fort Collins, CO 80521 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 �—Wa16"9� ©1988.2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD