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HomeMy WebLinkAbout107133 BATH INC - INSURANCE CERTIFICATE (2)Client#: 21043 BATIN Spy LR- ► s ACORD.. CERTIFICATE OF LIABILITY INSURANCE D10/252013 l 10/2512013 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: H the certificate holder Is an ADDITIONAL INSURED, the poliey(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 Flood & Peterson Ins., Inc. P. O. Box 578 Greeley, CO 80632 cD" E: Ac Jennifer Winter NAM PZCC"No Ellin:970 506J206 Ne; 970506 6846 ,EiopRDRD L . JWinter@floodpeterson.com INSURER(S) AFFORDING COVERAGE NAICi 970 356-0123 INSURERA: Bituminous Insurance 20095 INSURED R Bath, Inc. /O Il 3 2000 E. Prospect Road Fort Collins, CO 80525 INSURER B: St. Paul Fire & Marine Ins. Co. 24767 INSURER c Pinnacol Assurance 41190 INSURER D INSURER E INSURER F : r nVFRAAFS 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 CONTRACTOR 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 ADOLSUB R WV POLICY NUMBER POLICY EFF MWDD POLICY EXPO MWDDIYYYY A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE EXOCCUR X PD Ded:500 CLP3595079 11101/2013 11/0112014 EACHOCCURRENCE S1000 000 PMIBE agE of RE $100000 MED EXP (My one person) 11 O 000 PERSONAL &AOV INJURY $1 00O 000 GENERAL AGGREGATE s2 000,000 GENL AGGREGATE POLICY UNIT APPLIES PER: X PR0. LOC PRODUCTS - COMP/OP AGG $2000000 Is A AUTOMOBILE LIABILITY JANYOAUTO All WNED SCHEDULED AUTOSAUTOSNON-OED HIREDAUTOS X AUTOS Oth Car CAP3595080 1/011201311/011201 E;;BBIINeEDSINGLE LIMIT 1.000,000 BODILY INJURY(Per peri S BODILY INJURY(Per accident) $ 046PERTY DAMAGE PWa�dentrive S $ A B X X UMBRELLA Like EXCESS LIAR X OCCUR CLAIMS -MADE CUP2803536 ZUP13T9187713NF 1/0112013 1101/2013 11101/2014 11101/2014 EACH OCCURRENCE 31000000 AGGREGATE $11,000,000 I DED I X RETENTION IIOOOO1 Ea Occur 54000000 C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETORIPARTNEREXECUTIVE YIN OFFICER'MEMBER EXCLUDED? 51 (Mandatory In NM) RDES aPTIONescribe Ynaa DESCRIPTION OF OPERATIONS Osbr NIA 4015110 1/01/2013 11/0'1/2014 X I WCSTATU- OTH- E.L. EACH ACCIDENT $1 O00 900 E.L. DISEASE - EA EMPLOYEE E7 OOO 000 E.L. DISEASE -POLICY LIMn $1000000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is required) RE: Neighborhood Street Tree Replacement #7205 City of Fort Collins, its officers, agents and employees are listed as Additional Insureds as their interest may appear as respects General Liability and Auto Liability. Insurance is primary and non contributory. City of Fort Collins SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Y THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 281 N. College Avenue ACCORDANCE WITH THE POLICY PROVISIONS. Fort Collins, CO 80521 AUTHORIZED REPRESENTATIVE ©1988-2010 ACORO CORPORATION. All rights reserved. ACORD 25 (2010/05) 1 of 1 The ACORD name and logo are registered marks of ACORD #S837508/M837496 JZS