Loading...
HomeMy WebLinkAbout129302 HAGEMAN EARTH CYCLE INC - INSURANCE CERTIFICATE (5)Client#: 24703 HAGEA ACORD.. CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYY) 11 /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. Astatement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER NAME: C Angie Nissen Flood &Peterson Ins., Inc. _ PHONE 970 356-0123 970 506-6850 AI No Ezt: AIC No P. O. Box 578 ADDRESS: anissen@floodpeterson.com Greeley, CO 80632 970 356-0123 INSURER($) AFFORDING COVERAGE NAK: e INSURER A: Continental Western Group _ INSURED Hageman Earth Cycle, Inc. INSURER B: PInnacol Assurance 12 ��� 3501 E. Prospect Road INSURER C: Fort Collins, CO 80525 INSURERD: 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 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. �S TYPE OF INSURANCE RL IN SB O POLICYNUMBER POLICY M/DD� MTR MIDD� LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE 51OCCUR X PDDed:500 CWP234489331 2/0112013 12/01/2014 OECCCURRREENCE S100D OD0 oEACCHH PREMISEB Ee c alrD ce $100000 MED EXP (Any one perm) s5,000 PERSONAL & ADV INJURY $1000,000 GENERALAGGREGATE s2 000,000 GENL AGGREGATE LIMIT APPLIES PER: PRd LOC POLICY JECT PRODUCTS-COMP/OP AGO s2000,000 $ A AUTOMOBILE LIABILITY ANY AUTO ALLOWNED SCHEDULEDBODILY AUTOSNON-OWNED AUTOS CWP234489331 12f011201312/011201 COMBINED SINGLE LIMIT 1,000,000 BODILY INJURY(Per person) S IX INJURY (Per acddmt) ItAUTOSAUTOSHIRED PROPER DAMAGE Per accident) s $ A X UMBRELLA LIAB M LU1B ? L j( OCCUR CLAIMS -MADE CU236140831 2/01/2013 1210112014 EACHOCCURRENCE s2000000 AGGREGATE s2,000,000 DED RETENTIONS S B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY / N ANY PROPRIETOR/PARTNEWEXECUTNE YIN OFFICER/MEMBER EXCLUDED? 7 (Mandatory in NH) it yea, describe under DESCRIPTION OF OPERATIONS below N/A 4036218 0/01/201310/01/201 WCSraTu- OTH- E.L. EACH ACCIDENT $SOO OOO E.L. DISEASE - EA EMPLOYEE $500 000 E.L. DISEASE - POLICY LIMIT $500 000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarim Schedule, If mom space Is requ lmd) Cityof Fort Collins SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Risk Management Dept. ACCORDANCE WITH THE POLICY PROVISIONS. Attn: Darlene P.O. Box 580 AUTHORIZED REPRESENTATIVE Ft Collins . CO 80522 © 1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010105) 1 of 1 The ACORD name and logo are registered marks of ACORD #S$443241M844293 AXN Client#: 24703 HAGEA ACORD.. CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DO/YYVY) 11 /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 Flood & Peterson Ins., Inc. P. O. Box 578 Greeley, CO 80632 970356Al2INSURERsuRE N ME:CT Angie Nissen ac°NIT Ea::970 356.0123FAX ac No), 970 506.6850 EIEADDRSS. anissen@floodpeterson.com W S AFFORDING COVERAGE NAICa INSURER A: Continental Western Group INSURED Hagerman Earth Cycle, Inc. 3501 E. Prospect Road Fort Collins, CO 80525 INSURER B : Plnna001 Assurance INSURER C INSURERD: 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 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. l pR TYPE OF INSURANCE AO R WVD SUB POLICY NUMBER MMIDDY EFF Mal " UNITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITYPREMISES CLAIMS -MADE 51 OCCUR X PDDed:500 CWP234489331 210112013 12/01/2014 $1000000 pEACH �OCCURRENCE E Eom�rrOance $100000 NEDEXP(Any one person) $5000 PERSONAL SADVINJURY $1000000 GENERALAGGREGATE s2,000,000 GEN'L AGGREGATE POLICY LIMIT APPLIES PER: PRO.JECT LOC PRODUCTS-COMP/OP AGG $2,000000 $ A AUTOMOBILE LIABILITY X ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS X HIRED AUTOS X NON -OWNED AUTOS CWP234489331 2101/2013 12101/2014 COMBINED 1r000r000 BODILY INJURY Per person) $ BODILY INJURY Per accident) $ PROPERTY DAMAGE Per eccklent $ $ A X UMBRELLA LIAB EXCESS UAB X OCCUR CLAJMSMADE CU236140831 2/01 /2013 12101/2014 EACH OCCURRENCE s2 000 000 AGGREGATE s2,000,000 DED I I RETENTION $ IS B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNERIEXECUTIVEYI N OFFICERIMEMBER EXCLUDED? IN (Mandatory In NH) / yea tlea riles under DE SCRIPTION OF OPERATIONS bolos, NIA 4036218 101011201310101/201 WCsTATu- OTH. E.L. EACH ACCIDENT $500 000 E.L. DISEASE - EA EMPLOYEE $500000 E.L. DISEASE -POLICY LIMIT $500,000 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICUES (Attach ACORD 101, Additional Remarks Schedule, It more space is required) Re: Snow Removal City of Fort Collins Purchasing Department 215 N Mason 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 ACORD 25 (2010105) 1 of 1 #SB44320/M844293 ©1988.2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD AXN Client#: 24703 HAGEA ACORD,. CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD 11/27/2013073 Y) 1 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(les) must be endorsed. N 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 97035E-0123 CONTACT Angie Nissen FAX PHONE 970 356-0123 (A/C,Nq, 970 506-6850 ACNO Ez EDDRE anissen@floodpoterson.com ADDRESS: •'V•• P INSURER(S) AFFORDING COVERAGE NAIL• INSURERA: Continental Western Group INSURED Hageman Earth Cycle, Inc. 3501 E. Prospect Road Fort Collins, CO 80525 INSURER B : Pinnacol Assurance 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. 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. VTR TYPE OF INSURANCE NINSRLSUSR IWO POLICY NUMBER MMIDOY EFF POLICY EXP MOLIC YYYY LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE r7x OCCUR X PD Ded:500 CWP234489331 12/01/2013 12/01/2014 OCCURRENCE $1000000 pEAACCHH PREMISES aomrErrence $100000 MED EXP (Any one person) $S 000 PERSONAL a ADV INJURY $1 000 000 GENERAL AGGREGATE s2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: 17 POLICY 7 PRO- LOC PRODUCTS-COMP/OP AGO s2000000 $ A AUTOMOBILE LIABILITY ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS HIRED AUTOS X NON -OWNED AUTOS IX CWP2349331 48 2/01/201312/01/201 MBINEDsINGL LIMI 1,000000 BODILY INJURY(Per person) S BODILY INJURY(Per accident) s PROPERTYDAMAGEs Per accident S A X UMBRELLA ULB EXCESS LIAB X OCCUR CLAIMS -MADE CU236140831 2/01/2013 12/01/2011 EACH OCCURRENCE s2 OOO O00 AGGREGATE s2,000,000 DED I I RETENTION $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITYER ANY PROPRIETORIPARTNER/EXECUTIVE� OFFICERIMEMBER EXCLUDED? N (Mandatory In NH) R yee, dewft under DESCRIPTION OF OPERATIONS belts, NIA 403621.E 0101/2013 10/01/2014 WCSTATU- OTH- E.L. EACH ACCIDENT $500 000 E.L DISEASE - EA EMPLOYEE $500000 E.L. DISEASE - POLICY LIMIT $500 000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, It more space Is required) City of Fort Collins is listed as an Additional Insured in regards to General Liability. City of Fort Collins 215 N. Mason 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 ©1988.2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) 1 of 1 The ACORD name and logo are registered marks of ACORD #S844307/M844293 AXN Client#: 24703 HAGEA ACORD-. CERTIFICATE OF LIABILITY INSURANCE D11/272013ATE YY 11127/2013 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(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 endorsement(s). PRODUCER N ME: Angie Nissen Flood & Peterson Ins., Inc. PHONNo E 970 356-0123 Ar Nq,970 506.6850 aC Eal: P. O. Box 578 EA IESS, anissen@floodpeterson.com Greeley, CO 80632 INSURER(3) AFFORDING COVERAGE NAIe e 970 356-0123 INSURER A: Continental Western Group INSURED INSURER B: Pinnacol Assurance Hageman Earth Cycle, Inc. 3501 E. Prospect Road INSURER 0: Fort Collins, CO 80525 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 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 ADDLSUBR INSR WVD POLICY NUMBER POLICY EFF MMIDO POLICY EXP MM/DDA(M LIMBS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS-MADEOCCUR X PD Ded:500 CWP234489331 2/0112013 12/01/2014 $1000000 pEpAAqCCMHpp��OEECCURRENCE PREMISES eEOoa�irrence $100 000 MED EXP(Any one person) $5000 PERSONAL$ ADV INJURY $1,000,000 GENERAL AGGREGATE f2 000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRO-LOC POLICY JECT PRODUCTS -COMPIOP AGG $2000000 $ A AUTOMOBILE LIABILITY ANY AUTO ALL OWNED SCHEDULED AUTOS AUT AHIRED AUTOS X UTTOS CWP234489331 12MI1201312/01/201 COMBINED 1,000,000 BODILY I NJURY(Per person) $ IX BODILY INJURY(Peraccidenl) $ (Par aEcRtle DAMAGE$ f A X UMBRELlAL1AB EXCESS LIAR X OCCUR CLAIM&MADE CU236140831 2/01/2013 12101rA14 EACHOCCURRENCE s2.000,000 AGGREGATE s2,000,000 DED I I RETENTION $ B WORKERS COMPENSATION AND EMPLOYERS' UABILRY ANY PROPRIETOWPARTNER/EXECUTIVE YIN OFFICERMIEMBER EXCLUDED? FW (Mande" In NN) If yes, tlaacdha undar DESCRIPTION OF OPERATIONShelow NIA 4036218 0/0112013 10/01/201 TO STATU- OTH- E.L. EACH ACCIDENT $500000 E.L. DISEASE - EA EMPLOYEE s500000 E.L. DISEASE -POLICY LIMIT $500,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more apace is required) The City of Fort Collins is listed as an Additional Insured in regards to General Liability. City of Fort Collins 215 N. Mason 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 ACORD 25 (2010/05) 1 of 1 #S844304/M844293 © 1988.2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD