HomeMy WebLinkAbout102525 ALLEN PLUMBING & HEATING INC - INSURANCE CERTIFICATE (5)YY
CERTIFICATE OF LIABILITY INSURANCE I DA 6/10I2 Y013
O/10)
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
ce Group - JT
son Pkwy, Ste 200
CO 80534
Phone:970-635-9400
Fax:970-635-9401
10 V� ti�!
INSURED Allen Plumbing & Heating Inc.
& Allen Plumbing & Mechanical
& Allen Service
101 S. Link Lane
Fort Collins, CO 80524
COVERAGES CERTIFICATE NUMBER:
ALLEN-4
415
IINSURER R:Pinnacol Assurance 141190 1
REVISION NIIMRER-
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 CLAIMS.
PAID
ILTR TYPE OF INSURANCE IN RI UBRI POLICY NUMBER MMIODYYYYY MMIDDIYYYY LIMITS
GENERAL LIABILITY
EACH OCCURRENCE
$ 1,000,000
A
X COMMERCIAL GENERAL LIABILITY
C AIMS ADE I OCCUR
4X69971
03/0112013
0310112014
DAMAGE TO RENTED
RREMISES(Ea occurrence)
MED EXP (My one person)
$ 300,000
10,00
Blanket Addl Ins
PERSONAL It ADV INJURY
$ 1,000,00
X
Blanket Waiver
GENERAL AGGREGATE
$ 2,000,00
GEN'L AGGREGATE LIMIJECTT APPLIES PER
I I PRO
POLICY f XLOC
PRODUCTS-COMPIOPAGG
$ 2,000,00
$
A
AUTOMOBILE
X
LIABILITY
ANY AUTO
4X69971
0310112013
1310112014
COMBINED SINGLE LIMIT
(Ea accident)
$ 1,000,000
BODILY INJURY (Per person)
S
ALL OWNED AUTOS
BODILY INJURY (Per accident)
$
SCHEDULED AUTOS
HIREDAUTOS
PROPERTY DAMAGE
(Per accident)
$
X
X
$
NON -OWNED AUTOS
BlanketAOWaiver
X
$
UMBRELLA LIAR
I X
OCCUR
EACH OCCURRENCE
$ 5,000,000
N
AGGREGATE
$ 5,000,000
A
EXCESS LIAB
CLAIMS -MADE
4X69971
03/01/2013
03/0112014
DEDUCTIBLE
S
$
RETENTION $ 1D 000WORKERS
COMPENSATION
1� I I I
B
AND EMPLOYERS' LIABILITY Y/ N
ANY PROPRIETORIPARTNER/EXECUTIVE
OFFICERIMEMBER EXCLUDED'
Mandato In NH
( rY 1
DIf yes RIPTIdesuNunder
DESCRIPTION OF OPERATIONS below
NIA
(
IBLANKETWANEROF
4049622
SUBRO
0710112013
07/01/2014
xiTORV LAMITS L—OER_
EL.EACH ACCIDENT
$ 1,000,00
E.L. DISEASE - EAEMPLOYEE
$ 1,000,00
E.L. DISEASE -POLICY LIMIT $ 1,000,00
AI
Equipment -Leased
03/01/2013
03/10/2014
at 100,000
I4X69971
ID
DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space is mqulmd)
CITYOFC
City of Fort Collins
PO Box 580
Fort Collins, CO 805236
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
U 1555.2009 ACORD CORPORATION. All rights reserved.
ACORD 25 (2009/09) The ACORD name and logo are registered marks of ACORD