No preview available
HomeMy WebLinkAbout128847 CRYSTAL LANDSCAPE SUPPLIES INC - INSURANCE CERTIFICATE (7)CRYST-6 OP ID: LP 144c"H o CERTIFICATE OF LIABILITY INSURANCE D10/31ATE 12014"' 10/31I2014 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 Johnstown, CO 80634 Dave Janssen CONTACT AXONE Dave Janssen FAX AIc No EsI :970-635-9400 A/c NA : 970-635-9401 E-MAIL ADDRESS: ' - INSURER(S) AFFORDING COVERAGE NAIC a INSURER A: PInnacol Assurance Co 41190 INSURED Crystal Landscape Supplies Inc INSURER s:Employers'Mutual Casualty Co 6616 N Garfield Ave Loveland, CO 80538-1115 - - .- . INSURER c: INSURER D: INSURER E ' INSURER F COVERAGES i 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 U POLICY NUMBER POLICY EFF MMIDDIYYYY POLICY EXP MMIDDIYYYY LIMITS B X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 CLAIMS -MADE N OCCUR 4D84863 12/01/2014 12/01/2015 PREMISES Ea occTur ante $ 100,00 X MED EXP (Any one person) $ 5,000 Blkt AI by Agree PERSONAL S ADV INJURY $ 1,000,000 GENL AGGREGATE LIMIT APPLIES PER RO- X POLICY JECT PRO ❑ LOC GENERAL AGGREGATE $ 2,000,00 PRODUCTS - COMPIOP AGO $ 2,000,00 $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ 1,000,00 X BODILY INJURY (Per person) $ B ANY AUTO 4E84863 12/01/2014 12/01/2015 ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident I $ X X NON -OWNED HIREDAUTOS AUTOS PROPERTY DAMAGE Peraccident $ X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 1,000,00 AGGREGATE $ 1,000,00 B EXCESS LIAB I CLAIMS-AMDE 4JB4863 12/01/2014 12/01/2015 DED I X I RETENTION$ 10,000 $ A WORKERS COMPENSATION AND EMPLOYERS'LIABILITY ANY PROPRIETORIPARTNER/EXECUTIVE YIN OFFICER/MEMBER EXCLUDED' NIA 4041312 _ 06/01/2014 06/01/2015 X PER OTH- STATUTE X ER E.L. EACH ACCIDENT $ 1,000,00 E. L. DISEASE-EAEMPLOYEE $ 1,000,000 (Mantlatory in NH) I(yan describe in under DESCRIPTION Or OPERATIONS below - E. L. DISEASE -POLICY LIMIT IS 1,000,000 B Inland Marine 4CB4863 12 O112014 12/01/2015 Leased/Re 25,000 - - Ded 1,00 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached 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 Dave Janssen ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD