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HomeMy WebLinkAbout126682 A & M LANDSCAPE CONCEPTS INC - INSURANCE CERTIFICATE (2)A&MLA-1 OF ID: JL CERTIFICATE OF LIABILITY INSURANCE DATE IMMIDD I 08/O6I2013 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 endorsements . PRODUCER Phone: 720-962-0930 CONTACT Jessie Lee Six & Geving Insurance Inc #4 . Fax: 720-962.0942 Denver Branch - PHONE 303-653-0022 F"" _(ac, No`aD: IAIC No): 720-962-0942 E-MAIL e six- evin - ADDRESS: Jle@ 9 J .com 225 Union Blvd. #575 Lakewood, CO 80228 Nancy Kersey INSURER(S) AFFORDING COVERAGE NAIL # INSURERA: Pinnacol Assurance 41190 INSURED A & M Landscape Concepts, Inc. Allen Winter 749 S. Lemay Ave. PMB 221 INSURER B: INSURER C: Fort Collins, CO 80524 INSURER D INSURER E INSURER F: COVERAGES CERTIFICATE NUMBER: REVISIONNUMBER: 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 TYPE OF INSURANCE ADOL�SU D I POLICY NUMBER MMIDDOLICY IYEYYY LTR IDDIYYYY MMLIMITS GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY ri,kivlklE TO RENTED PREMISES Ea occurrence $ CLAIMS -MADE ❑ OCCUR MED EXP (Any one person) $ PERSONAL B ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS - COMPIOP AGG $ RO LOC POLICY PFCT $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident 8 BODILY INJURY (Per person) $ ANY AUTO AOSCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident)$ $ NON -OWNED HIRED AUTOS AUTOS UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAR CLAIMS -MADE DED RETENTION $ $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETORIPARTNERIEXECUTIVE YIN OFFICE WMEMBER EXCLUDED? � (Mandatory In NH) N I A 4115033 09/01/2013 09/01/2014 X WC STATU- OTH- TORY LIMITS ER E.L. EACH ACCIDENT $ 500,000 E.L. DISEASEEAEMPLOYEE $ 500,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT I $ 500,000 DESCRIPTION OF OPERATIONS I LOCATIONS 1 VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space is required) RE: Spring Canyon Playground Overflow Parking CTYFT-3 City of Fort Collins Purchasing PO Box 580 215 North Mason Fort 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. AUUTTH�O,RIZ�ED RREPPRRE'SENTATIVE `— © 1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD A&MLA-1 OP ID: JL ,a�o�ra CERTIFICATE OF LIABILITY INSURANCE D08/06/2013ATE ) 08/O6I2013 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 endorsements . ' PRODUCER Phone: 720-982-0930 Six & Geving Insurance Inc #4_ Fax: 720.962-0942 Denver Branch' - 225 Union Blvd. #575 Lakewood, CO 80228 CONTNAME ACT Jessie Lee PHONE 303-653.0022 - FAX _1AIC.No,ExtG (wc, a)*720.962-0942 - E-MAIL flee six- evin - ADDRESS: @ gg•Com - Nancy Kersey INSURER( AFFORDING COVERAGE NAIC # INSURER A: Plnnacol Assurance 41190 INSURED A & M Landscape Concepts, Inc. Allen Winter 749 S. Lemay Ave. PMB 221 INSURER B: INSURER C: Fort Collins, CO 80524 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. INSR TYPE OF INSURANCE INSRADDIWVDSUSR POLICY EFF POLICY NUMBER MMIDO YYYY MML ICY EXP LTR DDNYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ DAMAGETORENTED COMMERCIAL GENERAL LIABILITY PREMISES (Ea occurrence) $ CLAIMS -MADE F—IOCCUR MED EXP (Any one person) $ PERSONAL BADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMPIOP AGG $ POLICY 1 PRO I LOC upnT $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident $ BODILY INJURY (Perperson) $ ANYAUTO ALL OWNED ❑ SCHEDULED AUTOHREDSAUTOS BODILY INJURY (Par accident) $ AUTOS L�7 NON -OWNED - PROPERTY accid nDAMAGE $ is UMBRELLA LIAB OCCUR EACH OCCURRENCE s AGGREGATE $ EXCESS LIAR CLAIMS -MADE DED I I RETENTIONS I $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETORIPARTNEHIEXECUTIVE Y� UDED4 OFFICERIMEMBER EXCL (Mandatory In NH) Y NIA 4115033 09/01/2013 09/0112014 WC STATU- OTH- X TQRYLMIT$ R E.L. EACH ACCIDENT $ 500,000 E.L. DISEASE- EA EMPLOYEE $ 500,000 ft)•e9, de9f21undo! DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT 1 $ 500,000 DESCRIPTION OF OPERATIONS I LOCATIONS) VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) RE: All Projects/All Locations City of Fort Collins Purchasing or Risk Mgmt P.O. Box 580 Fort Collins, CO 80522 CTYFT-1 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 RREPPRRE'SENTATIVE `'— ACORD 25 (2010/05) © 1988-2010 ACORD The ACORD name and logo are registered marks of ACORD All rights reserved A&MLA-1 OP ID: JL A�aRa CERTIFICATE OF LIABILITY INSURANCE D08/06/2013ATE Y) 08I06/2013 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 endorsements . PRODUCER -- Phone:720-962-0930 Six & Geving Insurance Inc #4 Denver Branch' -' "- "' Fax:720-962.0942 225 Union Blvd. #575 Lakewood, CO 80228 CONTACT NAME' Jessie Lee PHONE FA% A/c No E„t.303-653.0022 - INC No): - E-MAIL lee Six- evin com ADDRESS:]_gg. ' - Nancy Kersey INSURER(S) AFFORDING COVERAGE NAIL k INSURER A: Pinnacol Assurance 41190 INSURED A & M Landscape Concepts, Inc. Allen Winter 749 S. Lemay Ave. Pill 221 INSURER B: INSURER L Fort Collins, CO 80524 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. INSR TYPE OFINSURANCE ADDL VIVO POLICY NUMBER MMI POLICY MM ICYYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ DAMAGE TO RENTED COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence $ CLAIMS-MADEI-J OCCUR MED EXP (Any one person) $ PERSONAL&ADV INJURY $ GENERALAGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS - COMP/OP AGG $ - POLICY F7 PR0 F7 LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ BODILY INJURY (Per person) $ ANY AUTO ALL OS SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ PROPERTY DAMAGE Peraccid $ NON -OWNED HIRED AUTOS AUTOS UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DED RETENTION$ $ A WORKERS COMPENSATION ANDEMPLOYERS'LIABILITY ANY PROPRIETORIPARTNERIEXECUTNEYIN OFFICER/MEMBER EXCLUDED? (Mandatory in NH) NIA 4115033 09/01/2013 09/01/2014 X TWO STATU- OTH- TCRY LIMITS ER EL EACH ACCIDENT $ 500,DD0 E.L. DISEASE- EA EMPLOYEE $ 500,000 It yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT 1 $ 500,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space is required) RE: Weed Mowing & Abatement CTYFT-4 City of Fort Collins Purchasing & Risk Management PO Box 580 Fort Collins, CO 80522 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 4- J © 1988.2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD