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COLORADO GREENHOUSE CONSTRUCTION LLC - INSURANCE CERTIFICATE
CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYY) 11012712014 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 CONTACT Diane DeVoe WIN Insurance Agency LLC PHONEEll 719632-7744 ac No: 719 597.6315 E-MAIL diane@winagency.com 3485 N. Academy Blvd INSURERISI AFFORDING COVERAGE NAIC# Suite 203 INSURER A: Western Heritage Insurance Company Colorado Springs CO 80917 INSURED INSURER B : Plnnacol Assurance INSURERC: Colorado Greenhouse Construction LLC INSURER D : PO BOX 38454 INSURER i Colorado Springs CO 80963-7 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 ADDLSUB POLICY NUMBER POLICY EFF IMMi POLICY EXP Mi LIMITS A COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR TBD 10i27/2014 10127/2015 EACH OCCURRENCE $1,000,000 X DAMAGE TO RENTED $100,000 MED EXP (Any oneperson) $5,000 PERSONAL B ADV INJURY $1,000,000 GENT AGGREGATE LIMIT APPLIES PER: X POLICY 0 JECT LOC HER GENERAL AGGREGATE s 2,000,000 PRODUCTS - COMPIOP AGG $2,000,000 $ AUTOMOBILE LIABILITY ANY AUTO ALL OWNED F7 SCHEDULED AUTOS AUTOS NON -OWNED HIRED AUTOS AUTOS COMBINED SINGLE LIMIT S BODILY INJURY (Per person) $ BODILY INJURY (Per accident)$ PROPERTY DAMAGE $ $ UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DIED I I RETENTION S I $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRETORPARTNEWEX OFFICER/MEM ER/EXCLU ED?ECUTIVE Y© (Mandatory In Ni If yes, describe under DESCRIPTION OF OPERATIONS haloes NIA TBD 10i27i2014 11/0112015 I PER 01 EL. EACH ACCIDENT $100,000 E.L. DISEASE - EA EMPLOYE $100,000 E.L. DISEASE- POLICY LIMIT 1 $ 500,000 DESCRIPTION OF OPERATIONS LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached U more space is required) Certificate Holder is listed as Additional Insured on the General Liability and waiver of subrogation applies to certificate holder. City of Fort Collins; Doug Clapp- Senior Buyer SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN PO BOX 580 ACCORDANCE WITH THE POLICY PROVISIONS. Fort Collins, CO 80522 AUTHORIZED ©1988.2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD Doug Clapp From: diane@winagency.com Sent: Monday, October 27, 2014 2:41 PM To: Mark Knoll Cc: Doug Clapp Subject: Colorado Greenhouse Construction LLC- Chand Johnson Attachments: Johnson_COI.pdf Mark, Attached is the certificate of insurance for Colorado Greenhouse Construction LLC. Please let me know if you need anything else from me. Thank you, Diane DeVoe Win Insurance Agency 3485 N Academy Blvd #203 Colorado Springs, CO 80917 Phone: (719) 632-7744 Fax: (719) 597-6315 1