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Home My WebLink About111134 MILL BROTHERS LANDSCAPE & NURSERY INC - INSURANCE CERTIFICATE (2)OP ID: SL '4t`�R" CERTIFICATE OF LIABILITY INSURANCE D06112ATE /2014 ) osnz/2o1a 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 PIPS Insurance Group - JT 4848 Thompson Pkwy, Ste 200 Johnstown, CO 80534 Dave Janssen - 1 CONTACT PHONE FAX (AIC No Ext): AIC No), E-MAIL ADDRESS: PRODUCER MILLB-2 CUSTOMER ID p: INSURER(S) AFFORDING COVERAGE NAIC p yt\ 1 INSURED Mill Brothers Landscape & Nursery, Inc., MB Design Group & MB Golf INSURER A: EMC Insurance Companies 21415 INSURER B: Pinnacol Assurance 41190 6121 E. Harmony Road INSURER C: INSURER D Fort Collins, CO 80528 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 LTR TYPE OF INSURANCE AbtiI S➢EIL POLICY NUMBER POLICY EFF MMIOD/YYYY POLICY E%P MMIOD/YYYY LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE [A] OCCUR X Blanket Add'I Ins 4X95754 07/01/2014 07/01/2015 EACH OCCURRENCE $ 1,000,00 E T PREMISES Ea occurtence $ 300,00 MED EXP (Any one person) $ 5,00 PERSONAL B ADV INJURY $ 1,000,00 X Blanket Waiver GENERALAGGREGATE $ 2,000,00 GENL AGGREGATE LIMIT APPLIES PER. 1-1 POLICY X PRO LOC PRODUCTS - COMP/OP AGG $ 2,000,00 $ A A A AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS 4X95764 07/01/2014 07/01/2015 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,00 X BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ X PROPERTY DAMAGE (PER ACCIDENT) $ X $ A UMBRELLA LAB EXCESS LAB X OCCUR CLAIMS -MADE 4X95754 07101I2014 07I0112015 EACH OCCURRENCE $ 2,000,00 AGGREGATE $ 2,000,0D DEDUCTIBLE RETENTION $ g $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNERIEXECUTIVEY OFFICER/MEMBER EXCLUDED? ❑ (Mendalcry in NH) If yes, describe under DE SCRIPTION OF OPERATIONS below NIA 3037064 BLANKET WAIVER OF SUBRO 07/01/2014 07/01/2016 WC STATU- OTH- X T RV LIMIT .L E. EACH ACCIDENT $ 1,000,00 E.L. DISEASE - EA EMPLOYEE $ 1,000,00 EL DISEASE -POLICY LIMIT S 1,000,00 A Leased/Rented 4C9575414 07/01/2014 07/01/2015 Limit 100,00 Deductibl 50 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (Alfach ACORD 101, Additional Remarks Schedule, If more space is required) RE: 7034 Cottonwood Glen Overflow Parking Lot Landscape 6 Irrigation. The City, its officers, agents and employees (see note attached) CITYFT3 City of Fort Collins P.O. Box 580 Ft. 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. AUTHORIZED REPRESENTATIVE ,yCfetQ�'.e+?P�� U 19BO-2009 ACORD CORPORATION. All rights reserved. ACORD 26 (2009/09) The ACORD name and logo are registered marks of ACORD No Text