HomeMy WebLinkAbout132133 EARTH ENTERPRISES DBA WASTE-NOT RECYCLING - INSURANCE CERTIFICATE (5)OP ID: NR
,d►`oRo CERTIFICATE OF LIABILITY INSURANCE
D061281201 YY)
06128/2013
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 pollcy(les) 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 endorsemerlt(s).
PRODUCER Phone: 970�35-9400
CONTACT
PFS Insurance Group - JT Fax: 970$35-9401
4848 Thompson III Ste 200
PHONE NC No
E-MAIL
ADDRESS:
Johnstown, CO 80534
John Hlntzman
PRODUCER EARTH-3
CUSTOMER ID r:
INSURERS) AFFORDING COVERAGE
NAIC r
r'
INSURED Earth Enterprises, Inc.
INSURERA:MountainStates Insurance Grp
Dba Waste -Not Recycling -
1085 Poplar Street
Loveland, CO 80537
INSURER B: Underwriters at Lloyds, London
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. NOTWRHSTAN DING ANY REQUIREMENT, TERM OR CONDIiICN 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 MAYHAVE BEEN REDUCED BY PAID CLAIMS.
L NSI
TYPE OFINSURANCE
POLICY NUMBER
POLICY EFF
POLICY E%P
LIMITS
GENERAL LIABILITY
EACH OCCURRENCE
$ 1,000,00
A
X COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE OCCUR
CPP0250701
06/0312013
0610312014
PREMISES aoccunence
$ 300,00
MED EXP (Any one person)
$ 10,00
X
BLKT ADD'L INSURED
PERSONAL B AOV INJURY
$ 1,080,00
X
GENERAL AGGREGATE
$ l 2,000,00
RIMARYINON-CONTRIBUTORY
GEN'L AGGREGATE
LIMIT APPLIES
PER
PRODUCTS - COMPIOP AGG
$ '2,000,00
X POLICY
PRO
LOC
$
A
AUTOMOBILE
LIABILITY
ANY AUTO
BAP0250704
06/03/2013
06/03/2014
COMBINED SINGLE LIMIT
(Eaaccident)
$ 1,000,00
BODILY INJURY (Per person)
$
ALL OWNED AUTOS
BODILY INJURY peer accident)
$
SCHEDULED AUTOSHIRED AUTOS
JX
PROPERTY DAMAGE(Per accident)
$
NON -OWNED AUTOS
Hired/Nom Owned
COMP DIED: $100
s
X
UMBRE ILA LIAR
X
OCCUR
EACH OCCURRENCE
$ 4,000,00
AGGREGATE
E 4,000,00
A
EXCESS LIAB
CLAIMS -MADE
CPP0250701
06/03/2013
06/03/2014
DEDUCTIBLE
$
X
$
RETENTION $ 0
WORKERS COMPENSATION
AND EMPLOYERS' LIABILBN YIN
ANY PROPRIErORIPARTNER/EXECUTIVE
OFFICERIMFMBER EXCLUDED?
NIA
N/A
WCSTATU- OTH-
TORY LIMIT ER
E.L. EACH ACCIDENT
$
EL DISEASE - EA EMPLOYE
E
(Mandatory In NH)
If yds.SCOF O describe
DERIPTION OF OPERATIONS Delow
E.L. DISEASE - POLICY UMIT
$
B
EROrs&Omissions
12LFSPLO442
06/03/2011
06/03/2014
E&O 1,000,00
A
POLLUTION
CPP0250701
06/03/2013
06/03/2014
POLLUTION 250,00
OESCRIPnONOFOPEMnONSILOCATIONSIVEIOCLES (Attach ACORD 101, AddMonal Remarks Schedule, If more span la redul red)
If required by written contract or written agreement, the certificate holder
is included as additional insured for ongoing operations under general
liability.
City of Fort Collins
Purchasing Division
P.O. Box 580
Fort Collins„ CO 80522-0580
CITYOFF
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
ACORD 25 (2009109)
ACORD
The ACORD name and logo are registered marks of ACORD
reserved