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Home My WebLink About120528 FORT COLLINS TREE CARE INC - INSURANCE CERTIFICATE (5)FORTCOL-09 MMATHEWS CERTIFICATE OF LIABILITY INSURANCE DATE 1 4/2/2014TYI 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 PRODUCER CO 80502 Pat Deaver (303) 776-5122 FAA Nn,e (303) 776-5495 INSURER(S) AFFORDING COVERAGE NAIC a INSURER A: Hartford Accident and IndemnityCompany 22357 INSURED ry INSURER 8: Twin Ciq Fire Insurance Company 29459 Fort Collins Tree Care, Inc 12652$ INSURERC: Pinnacol Assurance Company 41190 301 East Douglas Road INSURER 0: Fort Collins, CO 80524 INSURER E INSURER F : nnVFRAr:FS CFRTIFICATF NIIMRFR• REVISION Nt1MRER- 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 XDDLICTYPE OF INSURANCE L;SUBR POLICY NUMBER MM TR /ODYIYYYY MM/DO/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS-MADE T OCCUR 34UUNSR3900 03/05/2014 03/0512015 EACH OCCURRENCE $ 1,000,00 PREMISES Ea occurrence $ 300,00 MED EXP(My one person) $ 10,00 PERSONAL S ADV INJURY $ 1,DOD,00 GENL AGGREGATE LIMIT APPLIES PER. IRO LOC POLICY LX]JE OTHER:' GENERAL AGGREGATE $ 2,000,00 PRODUCTS - COMP/OP AGG $ 2,DOO,00 $ B AUTOMOBILE LIABILITY _ X ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS NOWOWNED X HIRED AUTOS X AUTOS 34UUNSR3900 03105/2014 03/05/2015 COMBINED SINGLE LIMIT Ee accitlen[ $ 1,000,00 BODILY INJURY (Per person) $ BODILY INJURY (Per awident) $ PROP TY AMA E Per amident $ $ UMBRELLA LIAR EXCESS LIAB. OCCUR CLAIMS,MADE EACH OCCURRENCE $ AGGREGATE $ DED RETENTION$ $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETORIPARTNER/EXECUTIVE YIN OFFICER/MEMBER EXCLUDED? (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below N/A 4148327 OSIO1I2O14 OS/O1/2015 X I SF TE ER EACH E.L. EACH ACCIDENT $ 100,00 E. L. DISEASE - EA EMPLOYE$ 1DD,DD E.L. DISEASE - POLICY LIMIT $ 500,00 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached It more space Is required) City of Fort Collins as Additional Insured as required by written contract per General Liability policy form. un, nvo nAMr-FI I ATInM SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Fort Collins Y THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Purchasing Division P O Box 580 AUTHORIZED REPRESENTATIVE Fort Collins, CO 80522 311A M D N © 1988.2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD