HomeMy WebLinkAbout121309 FOOTHILLS TREE EXPERTS INC - INSURANCE CERTIFICATE (7)ACORD
CERTIFICATE OF
LIABILITY
INSURANCE
ATE MMMQIVYYY)
OS/29/2013
05/29/2013
PRODUCER (970) 377-0638
Squires Insurance Solutions LLC
9
4025 Automation Way
Bldg B, Suite 4
Fort Collins CO 80525-
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
INSURERS AFFORDING COVERAGE
NAIC#
INSURED Z{ 1�0L�1
Foothills Tree &x It6 Inc.
Kevin Walker
3600 Canadian Parkway
Fort Collins CO 80524-
INSURERA: Hartford Fire Insurance
INSURER D: Sentinel Insurance Co Ltd
INsuseR c:Pinnacol Assurance
INsuPER D:
INSURER E:
COVERAGES
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY
REOUIREMEW, 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,
AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR
LTR
ADD'L
INSIPID
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
DATE(MNIDDMYI
POLICY EXPIRATION
DATE(MMIOD/YYI
LIMITS
A
X
GENERAL LIABWTY
34 WN QY8384
06/15/2013
06/15/2014
EACH OCCURRENCE
$ 1,000,000
X COMAIERCIALGENERALLIABIUTY
CLAIMS MADE FxIOCCUR
/ /
/ /
OAMAGETO RENTED
PREMISES Ea Occurrence
$ 100,000
MED PAP (Any one Person)
$ 5,000
PERSONAL S ADV INJURY
$ 1,000,000
GENERAL AGGREGATE
$ 2,000,000
/ /
/ /
CEN'LAGGREGATE LIMB APPLIES PER:
PRODUCTS - COMPIOP AGO
$ 2,000,000
POLICY JEQ LOC
/ /
/ /
BONDED
B
X
AUTOMOBILE
'X
LIABILITY
ANY AUTO
34 WN QY8384
06/15/2013
06/15/2014
COMBINED SINGLE LIMIT
(Ea a�eaeni)
$ 1,000,000
BODILY INJURY
(Per Person)
$
ALL OWNED AUTOS
SCHEDULED AUTOS
/ /
/ /
BODILY INJURY
(Per acaidar)
$
HIRED AUTOS
NONJOWNEB AUTOS
/ /
/ /
/ /
/ /
PROPERTY DAMAGE
(Per accident
$
GARAGE UA6ILTTY
ALTO ONLY - EA ACCIDENT
$
ANY AUTO
/ /
/ /
OTHERTHAN EAACC
$
$
AUTO ONLY: AGO
A
X
EXCESSIUMBRELLA LIABILITY
X OCCUR F-ICLAIMS MADE
34 HRN QY8629
06/15/2013
06/15/2014
EACH OCCURRENCE
4 11000,000
AGGREGATE
$ 1,000,000
4
$
/
/ /
$
XIDEDUCTIBLE/
X RETENTION $ 10,000
C
WORKERS COMPENSATION AND
EMPLOYERS' UAOILRY
4080571
05/01/2013
05/01/2014
1{ WC STATU- I OTH-
TORY LIMITS ER
E.L. EACII ACCIDENT
$ 500,000
ANY PROP RIETO RIPARTNERrEXECUTIVE
E.L. wsEAEE-EA EMPLUr"
L00,000
nFRrFR,uFLRFR FTfI I
If yea. tleSCAbe under
SPECIAL PROVISIONS delow
/ /
/ /
E.L.DISEASE - POLICY LIMIT
$ 500,000
A
OTHER PROP
34 WN QY8384
06/15/2013
06/15/2014
50,000
/ /
/ /
[US]IR
DESCRIPTION OF O P ERATI ON SILO CATIO NSIVEH IC LESIEXCLU SIONS ADDED BY ENDO PIS E M ENTIEPECIAL PROVISIONS
Tree trioning operations. Certificate Bolder is listed as Additional InOured on the policy as required by written
contract or permit an per policy forms and conditions.
John Stevens
City of Fort Collins
Forestry Division
413 South Bryan Ave
11125 (2001108)
970) 221-6707 I SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL
10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT
FAILURE TO DO 60 SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE
CO 80524-
L_PI
INS025 (DIOB).D6
Page 1 012
IMPORTANT
If the certificate holder is an ADDITIONAL INSURED, the poticy(ies) must be endorsed. A statement on this
certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
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).
DISCLAIMER
The Certificate of Insurance on the reverse side of this form does not constitute a contract between the issuing
insurer(s), authorized representative or producer, and the certificate holder, nor does A affirmatively or negatively
amend, extend or alter the coverage afforded by the policies listed thereon.
AUUKU 26(21)UMB)
INS025(oma).o6 AMS P4,2 W 2