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Home My WebLink About121309 FORT COLLINS TREE CARE INC - INSURANCE CERTIFICATEFORTCOL-09 PDEAVER ,d►�oi2o CERTIFICATEOF LIABILITY INSURANCE DATE 311012014rr) 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 CONTACT Box 847 IRmont, CO 80502 77sS122 INSURED INSURER s: Hartford Fire Insurance Company 19582 Fort Collins Tree Care, Inc 121309 INSURER C: PInnacol Assurance Company 41190 301 East Douglas Road INSURER D: Fort Collins, CO 80526 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 TR TYPE OF INSURANCEADDLSUBR POLICY NUMBER POLICY EFF ID0IYYYYl POD YEXP IMWODNYYYI DMITS A X COMMERCIALGENERAL LIABILITY CLAIMS -MADE 1XI OCCUR 34UUNSR3900 03/05/2014 03/05/2016 EACH OCCURRENCE $ 1'000,00 PREMISES Ea occurrence $ 300,00 MED EXP (Any one person) $ 10,000 PERSONAL S ADV INJURY $ 1,000,00 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY[KJECT �LOC OTHER: GENERAL AGGREGATE S 2,000,00 PRODUCTS AGG $ 2,000,000 $ B AUTOMOBILE LIABILITY _ X ANY AUTO ALL OWNED SCHEDULED AUTOAUTOS X H REDSAUTOS X NON -OWNED AUTOS 34UUNSR3900 03/05/2014 03/05/2016 MIN IN L LIMIT Ea accident) $ 1,000,00 BODILY INJURY (Per person) $ BODILY INJURY (Par accident) $ PROPERTY DAMAGE Per accident $ UMBRELLA DAB EXCESS LIAM OCCUR CLAMS -MADE EACH OCCURRENCE $ AGGREGATE S DED I I RETENTION$ $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE V� OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yea, describe under DESCRIPTION OF OPERATIONS below NIA 4148327 05MI12013 05/01/2014 �tI PER STATUTE ER E.L. EACH ACCIDENT $ 100,000 E.L. DISEASE - FA EMPLOYE $ 100,000 EL. DISEASE -POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS I LOCATIONS VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more apace Is required) City of Fort Collins as Additional Insured as required by written contract per General Liability policy form. City of Fort Collins Purchasing Division P O 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 '3w11 0'0N4& U 19bB-ZU14 ACOHu cUHrVnA I IUN. All rights reservea. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD