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HomeMy WebLinkAboutMIKE HALLORAN DBA LONGS PEAK TREE CARE - INSURANCE CERTIFICATEA� "® CERTIFICATE OF LIABILITY INSURANCE FDATE 6/4/2013vvv) 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 endomement(s). PRODUCER First Mainstreet Insurance, LLC 275 S. Main Street, Suite 100 P.O. Box 847 Longmont CO 80502 CONTACT Karen Sterkel NAME: PHONE (303) 776-5122 AA/XC No: (303)776-5495 Epp IL .ksterkel@firstmainstreet. corn INSURERS AFFORDING COVERAGE NAICN INSURER A:HartfOrd 00914 INSURED Mike Halloran DBA: Longs Peak Tree Care, American Tree 2641 Betts Circle Erie CO 80516 INSURER B:Pinnacol Assurance INSURER C: INBURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:12/13 Revised 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 ABBE POLICY NUMBER POLICY EFF MM/DDNYYY POLICY EXP MM/DDNYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 PREMISES Eaoccurtonce $ 300,000 A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE aOCCUR 34UENSR5769 /7/2012 /7/2013 MED EXP(Any one person) $ 10,000 PERSONAL B ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GENT AGGREGATE LIMIT APPLIES PER PRODUCTS - COMP/OP AGG $ 2,000,000 X POLICY PRO LOG $ AUTOMOBILE LIABILITY EOMBINdEDt SINGLE LIMIT $ 1,000,000 X BODILY INJURY (Per person) $ A ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS 34UENSR5769 /7/2012 /7/2013 BODILY INJURY (Per amident) $ X HIRED AUTOS X NON -OWNED AUTOS PROPERTY DAMAGE Per accident $ Uninsured motorist el -single $ 1 000 000 UMBRELLA LIAR OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS UI B CLAIMS -MADE DED RETENTION $ $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y I NER ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) NIA 4158355 /r/2013 /1/2014 X WCSTATU- OTH- E.L. EACH ACCIDENT $ 100,000 E. L. DISEASE - EA EMPLOYE $ 100 000 It yes, describe under DESCRIPTION OF OPERATIONS belay E.L. DISEASE- POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, U more apace Is required) City of Fort Collins as Additional Insured if required for permit or by written contract per General Liability policy form. rzentz City of Fort Collins PO Box 580 Fort Collins, CO 80522 com ISHOULD 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 Sterkel/JUCMAN'�� ACUKU 25 (Z01U/05) INS025 (201005).01 ©1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD