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HomeMy WebLinkAbout111134 MILL BROTHERS LANDSCAPE & NURSERY INC - INSURANCE CERTIFICATEUN ID: Hu ,4c Ro a' CERTIFICATE OF LIABILITY INSURANCE DATE(MNVDDIYYYY) ��_ 06/27/2013 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: 970-635-940C PFS Insurance Group - JT 4848 Thompson Pkwy, Ste 200 Fax: 970-635-9401 Johnstown, CO 80534 INSURED Nursery, Inc., MB Design Group & MB Golf 6121 E. Harmony Road Fort Collins, CO 80528 COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: 190 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 BYPAIDCLAIMS. INTRR ADDTYPE OF INSURANCE INSR MD POLICY NUMBER MWDDYYYYY MhO1FOplYYYY LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE FxI OCCUR X Blanket Add'I Ins 4X95]54 0710112113 07/01/2014 EACH OCCURRENCE DAMAGE TO RENTED PREMISES Eaoccurrence) $ 1,000,00 I $ 300,00 MED EXP (Any one person) $ 5,00 PERSONAL INJURY $ 1,000,00 X Blanket Waiver GENERALAGGREGATE $ 2,000,00 GENT AGGREIIG��AAT�TE LIMIT APPLIES PER: POLICY A PRO F LOC PRODUCTS-COMPIOP AGG $ 2,000,00 4 A A A AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIREDAUTOS NON -OWNED AUTOS 4X95754 07/01/2013 07/01/2014 COMBINED SINGLE LIMIT ieenp $ 1,000,000 X BODILY BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ X X $ A UMBRELLA LIAB E%CESS LIAB V J( OCCUR 1 CLAIMS -MADE 4X95754 07I01I2013 07I01I2014 EACH OCCURRENCE $ 2,000,00 ILI AGGREGATE $ 2,000,000 DEDUCTIBLE RETENTION $ $ $ B WORKERS COMPENSATION AND EMPLOYERS'LIABILITY ANY PROPRIETORJPARTr , XECUTIVE YIN OFFICERIMEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below NIA 3037054 BLANKET WANER OF SUBRO 07/01/2013 07/01/2014 X WC STATU- OTH- TORV-LIMITS ER EL EACH ACCIDENT $ 1,000,00 EL DISEASE - EA EMPLOYEE $ 1,000,00 E.L. DISEASE -POLICY LIMIT 1 $ 1,000,00 DE CRIPTION OF PERATIONS I LOCATIONS I VEHICLES (Attach Ace RD 101, Additional Remarks Schedule, it more space Is required) T-} 7034�ttonwood Glen Overflow Parking Lot Landscape & Irrigation. The C�tp;—its officers, agents and employees (see note attached) CITYFT3 City of Fort Collins P.O. Box 580 Ft. Collins„ CO 80524 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 AIOA ate_ ©1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009/09) The ACORD name and logo are registered marks of ACORD (NOTEP"D:- HOLDER CODE CITYFT3 MILLB-2 PAGE INSURED'S NAME Mill Brothers Landscape & OP ID: RC DATE 08127�13 red by written contract or written agreement the following ns apply subject to the policy terms, conditions limitations and ns: The referenced (excluding Professional Liability) are included ional Insured for ongoing operations under General Liability and ed Insured under Automobile Liability (except Hired and Non -Owned le) A Waiver of Subrogation applies to those named above for Liability Automobile Liability and Workers' Compensation. ual Liability is included. Umbrella provides excess coverage over ral Liability, Automobile Liability and Employers Liability. This e will apply on a primary, non-contributory basis. UP IU: KU .acoRQ° `CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDOIYYYY) 1 06127/2013 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 PRODUCER Phone: PFS Insurance Group -JT Fax: 4848 Thompson Pkwy, Ste 200 Johnstown, CO 80534 Dave Janssen INSURED Mill Brothers Landscape & INSURER A: EMC Insurance Companies 21415 Nursery, Inc., MB Design Group INSURER B: Pinnacol Assurance 41190 & MB Golf 6121 E. Harmony Road INSURERC: Fort Collins, CO 80528 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. ILTR TYPE OF INSURANCE AOOLI MDII POLICY NUMBER MMIODYIYYYY MDEDDTYYYY LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS�dAGE a OCCUR X Blanket Add'I Ins 4X95754 1710112013 07I07I2014 EACH OCCURRENCE DAMAGE TORENTED pREMISES(Ea occurrence) $ 1,000,000 $ 300,000 MED EXP (Any one person) $ 5,00 PERSONAL &ADV INJURY $ 1,000,00 X Blanket Waiver GENERAL AGGREGATE $ 2,000,000 GEENL AGGRE ATATELIMIT APPLIES PER: POLICY R I PR T n LOC PRODUCTS-COMPIOP AGG $ 2,000,00 $ A A A AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS D NONOWNEAUTOS 4X95754 0710112013 07101/2014 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 X BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ X A UMBRELLA LIAB EXCESS LIAB X OCCUR GLAIMS�v1ADE 4X95754 07101/2013 07I01I2014 EACH OCC URRENCE $ 2,000,000 AGGREGATE $ 2,000,00 DEDUCTIBLE RETENTION $ $ Is B WORKERS COMPENSATION ANDEMPLOYERTLIABILITY ANY PROPRIETORIPARTNERIEXECUTIVE YIN OFFICERRMEMBER EXCLUDED? (Mandatory In NH)If yes, describe under DESCRIPTION OF OPERATIONS below NIA 3037064 BLANKETWAWEROFSUBRO 07/01/2013 07101/2014 WC STATU- OTH- X TORYLIMITS ER EL. EACH ACCIDENT $ 1,000,00 E.L. DISEASE -EA EMPLOYEE$ 1,000,00 E. L. DISEASE -POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) L OPERATIONS — ALL LOCATIONS. ARBORIST LICENSE. CITYOFF City of Fort Collins City Forester Forestry Division P.O. Box 580 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 ©1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009/09) The ACORD name and logo are registered marks of ACORD INOTEPA D. HOLDER CODE CITYOFF MILLB-2 PAGE 1 INSURES NAME Mill Brothers Landscape & OP ID: RC DATE 06/27/13 If required by written contract or written agreement the following red under Automobile Liability (except Hired and Non -Owned Waiver of Subrogation applies to those named above for ty Automobile Liability and Workers' Compensation. bi�ity is included. Umbrella provides excess coverage over bility, Automobile Liability and Employers Liability. This apply on a primary, non-contributory basis.