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HomeMy WebLinkAbout128847 CRYSTAL LANDSCAPE SUPPLIES INC - INSURANCE CERTIFICATE (6)OP ID: VM '4`� CERTIFICATE OF LIABILITY INSURANCE D05/06ATE /2014 ) os/os/zola 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 PFS Insurance Group -JT 4848 Thompson Pkwy, Ste 200 CONTACT PHONE FA% A/C No Eau, A/C No : Johnstown, CO 80534 Dave Janssen 1-ADDRESS: ILIl1 EMAIL PRODUCER CRYST-6 CUSTOMER ID, INSURER(] AFFORDING COVERAGE NAICN INSURED Crystal Landscape Supplies Inc INSURER A: Pinnacol Assurance 41190 6616 N. Garfield Ave. Loveland, CO 80538-1115 INSURER B: EMC Insurance Companies 21415 INSURER C INSURER D: INSURER IS 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 ADDL SUB POLICY NUMBER POLICY EFF MMIDD/YYYY POLICY E%P MMIODIVYYY LIMITS B GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY C1.AIMS1dADE I —XI OCCUR X Blkt Alby Agree 4X84863 12/01/2013 12/01/2014 EACH OCCURRENCE $ 1,000,00 ` E Ttv PREMISESTO RE Eaoccu..nce $ 100,00 MED EXP (Any one person) $ 5,00ii PERSONAL B ADV INJURY $ 1,000,00 GENERAL AGGREGATE $ 2,000,0010 GENT AGGREGATE LIMIT APPLIES PER: T POLICY PRO ECTLOC PRODUCTS - COMP/OP AGG $ 2,000,00 $ B AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIREDAUTOS NON -OWNED AUTOS 4X84863 12/01/2013 12/01/2014 COMBINED SINGLE LIMIT (Ea accident) S 1,000,00 X BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (PERACCIDENT) $ X X Comp Ded $ 1,00 Coll Ded $ 1,00 B X UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS -MADE 4X84863 12101/2013 12/01/2014 EACH OCCURRENCE $ 1,000,00 AGGREGATE $ 1,000,0O RETENTION $ 10,000 $ XdDEDUCTIBLE $ A WORKERS COMPENSATION AND EMPLOYERS' LMBILITY ANY PROPRIETOR/PARTNER/EXECUTIVE YIN OFFICERIMEMBER EXCLUDED? (Mandatory in NH) I/ es, describe under DESCRIPTION OF OPERATIONS below NIA 4041312 06/01/2014 06/01/2015 X I WCSTATU- X OTH- T RV LIMIT R EL EACH ACCIDENT $ 1,000,00 E.L. DISEASE - EA EMPLOYEE $ 1,000,00 E.L. DISEASE -POLICY LIMIT $ 1,000,00 B (Inland Marine (4X84863 12/01/2013 12/01/2014 Leased/Re 25,00 Ded 1,00 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remari s Schedule, If more space is required) If required by written contract or written agreement, the City of Fort Collins is included as Additional Insured for ongoing operations under General Liability. CITYOFC City of Fort Collins 215 North Mason Street Fort 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 ga: 10 a..'TyG� © 1988-2009 ACORD CORPORATION. All rinhfs reenrved ACORD 25 (2009/09) The ACORD name and logo are registered marks of ACORD