HomeMy WebLinkAboutLOVELAND PLUMBING LLC - INSURANCE CERTIFICATE^� �® CERTIFICATE OF LIABILITY INSURANCE
DATE(MMIDD/Y YY)
7/3/2014
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
JASON D PERCHA (16746)
4190 N GARFIELD AVE STE 1
LOVELAND, CO 80538-0000
CONT
NAMEp CT JASON D PERCHA
PHONE FAX 970-667-9317
, 970-667-0038 AIc Net
A ...ss: JASON.PERCHA@COUNTRYFINANCIAL.COM
INSURERS AFFORDING COVERAGE
NAIL y
INSURER A: COUNTRY Mutual Insurance Company
20990
INSURED 0817392
INSURER B:
INSURER C:
LOVELAND PLUMBING LLC / % GROSS BRIAN C
4358 RED FOX CT
LOVELAND, CO 80537
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 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
R
rypE OF INSURANCE
ADDL
SUER
POLICY NUMBER
MMIDDYEFF IYYYY
MMIDD/YYYY
LIMITS
GENERAL LIABILITY
COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE OCCUR
EACH OCCURRENCE
$
AMA T D
PREMISES Ea ceeumence
$
MED EXP(my one person)
$
PERSONAL S ADV INJURY
$
GENERAL AGGREGATE
$
GEN'L AGGREGATE
POLICY
LIMIT APPLIES PER:
PRO- LOC
PRODUCTS - COMP/OP AGO
$
$
A
AUTOMOBILE LIABILITY
ANY AUTO
ALL OWNED SCHEDULED
AUTOS NON —OWNED
HIRED AUTOS AUTO$
AM6818719
Covered on Businessowners
/28/2014
6/28/2015
COMBINED SINGLE LIMIT
Ea accident
BODILY INJURY (Per Person)
$
BODILY INJURY(Peraccident)
$
PROPERTY DAMAGE
Peracdclent
$
$
UMBRELLA LIAB
EXCESS LIAB
OCCUR
CLAIMS -MADE
EACH OCCURRENCE
$
AGGREGATE
$
DED I I RETENTION$
$
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITYANY PROPRIETORIPARTNEWEXECUTIVE Y❑
OFFICERIMEMBER EXCLUDED?
(Mandatory In NH)
I/ yes, descnbe under
DESCRIPTION OF OPERATIONS below
NIA
WC STATU- OTH-
E.L. EACH ACCIDENT
$
E L DISEASE - EA EMPLOYE
$
E L. DISEASE -POLICY LIMIT
$
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is required)
THE CITY OF FORT COLLINS
PO BOX 580
FORT COLLIN, 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.
AUTHORU:ED REPRESENTATIVE
(eJ 1988.2010 ACORD CORPORATION. All rights reserved.
ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD