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Home My WebLink About391001 WATERWISE LAND AND WATERSCAPES INC - INSURANCE CERTIFICATE (3)THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. Polity Number: 60434-35-32 IZ111114 C NICI i Effective Date of Change: 01/23/15 Expiration Date: 12/01/15 Change Endorsement No.: 004 Agent: 07-08-348 Named Insured: WATERWISE LAND & WATERSCAPES 1121 N LEMAY AVE FORT COLLINS CO 80524 The following item(s): E4277 I$I E&lion Insured's Name Insured's Mailing Address Policy Number Company Effective / Expiration Dace Insured's Legal Status / Business of Insured Payment Plan Premium Determination X Additional Interested Parties Coverage Forms and Endorsements Limits / Exposures Deductibles Coveted Property / Loc pion Description Classification / Class Codes Razes Underlying Insurance is (are) changed to read [See Additional Page(s)}: The above amendments result in a change in the premium as follows: No Changes I I To Be Adiusted At Audit I Additional Premium I Return Premium Authoritcd Representative Signature: FARMERS INSURANCE 914M ISIEDIDON 7W IMumn(gPiaYlad Wing lmwenn fnriw0lfiu, Im, rOh ib ginivm. 1497101 RUE I OF 2 E42714DI Policy Changes Endorsement Description VIN: JALE51314317901553 2005 FORD F550 SUPER VIN: IFDAF57P65EB41065 2013 HONDA MV EX-L VIN: 5J6RM4H73D L0l B l55 Removal If Covered Property is removed to a new location that is described on this Policy Change, Permit you may wmd this insurance to include that Covered Property at each location during the removal. Coverage at each location will apply in the proportion that the value at each location bears to the value of all Covered Property being removed. This permit applies up to 10 days after the effective date of this Policy Change: after that, this insurance does not apply at the previous location. 9142R IR FOIOON M IMW lw"NM W.od, I... i.0. Olfiu, I.., a h 1, FQMW PW 2 OF 2 N21i{OI Common Policy MID-CENTURY INSURANCE COMPANY Declarations IA STOCK COMPANY) aeaiess 0176 Fanner; Lum a Gnq 01 Gq�ies Nam OiFia: 4680 Wdshim ll Los Aareks, Gflerre 90010 ARTISAN CONTRACTORS - PREMIER 1. WATERWISE LAND Be WATERSCAPES F003881718-001-00001 Named Imme d - 1121 N LEMAY AVE Account Number Prod. Count Mailing 07-08-348 60434-35-32 Address; FORT COLLINS CO 80524 Agent No. Policy Number The named insured is an individual unless otherwise stated: ❑ Partnership ® Corporation ❑Joint Venture ❑ Organization (Any other) Typeof Business LANDSCAPE GARDENING 2. Policy Period from 01 /23 / 15 (not prior to time applied for) to 12/ 01 / 15 12:01 am. Standard Time If this policy replaces other coverage that ends at noon standard time of the same day this policy begins, this policy will not take effect until the other coverage ends. This policy will continue for successive policy periods as f.HGws: If we elect to continue this insurance, we will renew this policy if you pay the required renewal premium for each successive policy period subject to our premiums, rules and forms then in effect. This Policy Consists Of The Following Coverage Parts Listed Below And For Which A Premium Is Indicated. This Premium May Be Subject To Change. Premium After AOnllcable Discount and Modification BUSINESSOWNERS POLICY $5,266.00 BUSINESS AUTO POLICY $13,946.00 EMPLOYEE BENEFITS LIABILITY COVERAGE PART $82.00 EMPLOYMENT PRACTICES INSURANCE COVERAGE INCLUDED CYBER LIABILITY AND DATA BREACH COVERAGE $30.00 CERTIFIED ACTS OF TERRORISM - SEE DISCLOSURE ENDORSEMENT INCLUDED Total 'see Additional FerInformation below See Invoice Attached FARMERS INSURANCE 5"Iff 15TEDMON 613 (6169101 Pope I of ] 5661694DI Forms applicable to all Coverage Parts: E4277-ED1 IL00030498 IL00171198 25-3065 56-5166EDS E0022-ED1 Countersigned BY (Date) (Authorized Representative) Agent DAVID STANSFIELD Agent Phone: 970-204-0020 Additional Fee Information The following additional fees apply on an account, not a per -policy, basis. ' A service fee will be assessed on every installment invoice and will be included in the minimum amount due. However, if you choose to pay the entire account balance in full upon receipt of the first installment, the fee will be waived. In addition, for accounts fully enrolled in online billing and scheduled for recurring Electronic Funds Tunafn (EFT) payments the fee will be waived. Seam I..ud mmt Fee All sums except Florida, New Jersey and West Virginia $6.00 Florida 18% of outstanding balance. annualized, subject to $6.00 cap New Jersey $7.00 Weat Virginia $5.00 ' A retutved payment Fee apples per check, electronic transaction or other remittance which is not honored by your financial institution for any reason including but not limited to insufficient funds or a dosed acrount. NOTE: If the retansed payment a in napse se to a Neon of Ca seel/ation, coverage still cancels on the mnallation effective date setforth in the notice. Sum NSF Fee All states except Florida, Indiana, Maine, Nebraska, New Jersey, North Dakom, Oklahoma, Virginia, and West Virginia $30.00 North Dakota and Oklahoma $25.00 Nebraska and Indiana $20.00 Florida and West Virginia $15.00 Maine $10.00 New Jersey and Virginia Not applicable e A late fee will be assessed on cash Notice of Cancellation that is issued and will be included in the minimum amount due. State - Late Fee All states except Florida, Maryland, Missouri, Nebraska, New Jersey, Rhode Island, Virginia and Wen Virginia $20.00 Maryland, Nebraska and Rhode Island $10.00 Florida, Missouri, New Jersey, Virginia and West Virginia Not applicable The following applies on a peo-policy basis. ' A miusutement fee of $25.00 will be assessed if the policy is reinstated over 30 days but under 6 months from the canceVation date. This fee does narapply to Florida, Indiana &Maryland or to Worker' Compemahon pahtir. One or more of the fees or charges described above may be deemed a part of premium under applicable state law. 566169 IN601R0N 613 (610102 Pops 2 d 2 568169{DI BUSINESS AUTO 'DECLARATIONS MID-CENTURY INSURANCE COMPANY POLICY MEMBERS OF FARMERS INSURANCE GROUP OF COMPANIES LX I COVERAGE PART HOME OFFICE: 4680 WILSHIRE BLVD., LOS ANGELES, CALIFORNIA 90010 REM ONE NAMED WATERWISE LAND & WATERSCAPES F003881718-001-00001 INSURED Numbet °T�� MAILING 1121 N LEMAY AVE 07-08-348 60434-3S-32 ADDRESS 0W Icy rugm FORT COLLINS CO 80524 Type of The named insured is an individual ❑ Partnership ❑% Corp. Business LANDSCAPE GARDENING unless otherwise stated: ❑ Joint Venture ❑ Organization (Other than Partnership or joint venture) Policy Period from 01/23/15 (not prior to time applied for) to 12/01/15 12:01 AM Standard Time If this ppolicy topt=& other coverages that end a noon standard time on the same day this policy begins, this policy will not take effea until the other coverage ends. This policy will continue for su=uive pofiry periods as follows: If we elect to continue this insurance, we will renew this policy if you pay the requited renewal premium for each successive policy period subject to our premiums, rules and forms then in effect. REM TWO SCHEDULE OF COVERAGES AND COVERED AUTOS 'This policy provides only those coverages where a charge is shown in the premium column below. Each of these coverages will apply only to those "autos" shown as covered "autos . "Autos" are shown as covered "autos" for a particular coverage by the entry of one or more of the symbols from the COVERED AUTO Section of the Business Auto Coverage Form next to the name of the coverage. ROVERED AUTOS LIMF THE MOST WE WILL PAY FOR COVERAGES ANYONE ACCIDENT OR LOSS PREMRMA LNM SHOWN IN THOUSANDS LIABILITY 7 S 1000 9,199.00 PERSON ALINIU fore uiva ent Na-FaRY Pult ROTECTION Coverage) SEPARATELY STATED IN EACH PIP ENDORSEMENT ADDED PERSONAL INJURY PROTECTION (or equivalent added no-fault ay.) SEPARATELY STATED IN EACH ADDED PIP ENDORSEMENT PROPERTY PROTECTION INSURANCE SEPARATELY STATED IN THE P.P.I. ENDORSEMENT MINUS (Michigan only) S DEDUCTIBLE FOR EACH ACCIDENT AUTO MEDICAL PAYMENTS 7 S SEE SCHEDULE 223.00 UNINSURED MOTORIST 7 S SEE SCHEDULE 1,079.00 UNINSURED MOTORIST S PROPERTY DAMAGE UNDERINSURED MOTORISTS (Whennot 7 S incl. in Uninsured Motorists Coverage) pp whicheveris (ash YSEE�SCHEtp PHYSICAL DAMAGE COMPREHENSIVE COVERAGE 7 kss minus Sctual LE Ded. for Covered Auto. �of no Deductible ApplI'esto loss Teased by Fire or 'autos 1,001.00 U htnin . See Item Four Mr hired or borrowed . PHYSICAL DAMAGE SPECIFIED CAUSES OF LOSS COVERAGE 7 Adu Cas You 0 osto a air, c ev ri LLess us 2 I�Qd. r E c LPov re Auto %�ri ss chiefor an%,it PSeeltemFour�orhired (aAloer]� ti'Auto'. or Autos . PHYSICAL DAMAGE Actual Cash Value or Cost of Repair whkhever is COLLISION COVERAGE 7 less minus S SEE SCHEDULE De . For Each Covered 2,240.00 Auto. See Dem four kr hired or burr Autos . 7 S soo auto.' 34.00 TOWINGANDIABOR ACTUAL LIMIT)covers PREMIUM FOR ENDORSEMENA 170.00 FSIMTEDTOTALPREMIUM 13 946.00 FARMERS INSURANCE Sb5190 on EDITION b10 (5170601 PAGE IOr9 56519UD6 60434-35-32 Policy Number BUSINESS AUTO DECLARATIONS(ConNnued) ITEM THREE SCHEDULE OF COVERED AUTOS YOU OWN DESCRIPTION TERRITORY PURCHASED Y al TTr�q ryartm�ee�� Ruudy Typ Seriattjlim er (S) Te kl�itlentitimtion vNumber sown & State where Covered Auto will he principally garaged Qrigipam A a 8 AtON� 0 0. VY�i snsl 5StL0O 0 FORT COLLINS 2 2 96 CfEVROLETXEB7526�LUB CAB P K2500 22689 FORT COLLINS CO 2 3 92 5p�4R6D2663NKA5712§gUPER CAB F250 19246 FORT COLLINS CO 2 4 05 FFiFoTgNDX26G3NKA57125CHEW PICKU F350 SUPER 30195 FORT COLLINS CO 2 7 06 CAB P PTL TELL iANBE`11P25EB7483C2C 7500 FORT COLLINS CO 2 6 161018454LUB CLASSIFICATION Fxceptfor towing, all physical damage a cos o usmess use Size a rTmary con a perdition s-servi[e Cgoryeh. roup 1inpp stingg loss is payable to you and the less r- retail kming a0ol cv payeenamed below as interests Ia. m �o c- commercial Lapaciry may appear atthe time ofthe loss. Autort� 12500 10000 K 4 50 2 000 B 0 0 1 A rm Bence 0 0 u01 or Imo entry In any column below means that the Imo or urn entry In 1 e comes on in ITEM iY(U column applies instead LIABILITY PER1SeONAL PROTECTION ADyDgE6D P.LP.. PROP. PROT. Mi a ma Premium INJURY nA ntl minun remium �aAtY 1. 1negc A end mine duct.��".1,I. emmm �� dueihheshownuenow lown�elow UtorNo. remmm 2 1000 :go 7 1000 2 .0 total Premium 3,033.0 Bence a a e U01 a or limit entry In any (a umn a means Not t B Imo or uch a entryIn } e comes ondin ITEMIM'�column a lies instead) AUTO MED. PAY Covered PROPERTY DAMAGE Auto No. img remium *Lima Premium ' ImR Premium ' imit Premium 2 1 .0 g 4 13.081888 86.0 7 2.00 Ota Premium 78.00 344.0 corres ondin Bence at a deductible or Imo entry In any coumn a means 1 of 1 e Imo or O e—e—nify—in—Ilie ITEM iY/O Column applies instead) CCA m phstluc Premium limit Stu It stat remiumDisimd Per aaent Premium utor� . Premium �wm, ei� sfwa 1 00 500 .00 00 103.00 q3 500 IS 7 08 ME ota Premium 253.00 501.00 TONG TS SHOWN III THOUSANDS) 5699061HEDIDON 3.10 (SIM? PAG11o93 S65190,06 6D434-35-32 DECLARATIONS (CONTINUED) Poky Nuer RED OR BORROWED COVERED AUTO COVERAGE AND PREMIUMS PREMIUM Cost of hire means the total amount you incur for the hire of "autos" you don't own (not including "autos' you borrow or rent from your employees or their family members). Cost of (tire does not include charges for services performed by motor carriers of property or passengers. PHYSICAL DAMAGE COVERAGE LIMIT ESANNUAL S PER PREMIUM COVERAGES THE MOST WE WILL PAY EACH $100 DEDUCTIBLE COST OF HIRE COST OF HIRE S WHICHEVER IS LESS MINUS COMPREHENSIVE S DED. FOR EACH COVERED AUTO. BUT NO DEDUCTIBLE APPLIES TO LOSS CAUSED BY FIRE OR LIGHTNING. SPE43FIED S WXI[HST ERIS LESS MINUS CAUSES of LOSS $25 DID. FOR EACH COVERED AUTO FOR LOSS CAUSED BY MISCHIEF OR VANDALISM. COLLISION $ WHICHEVER IS LESS MINUS S DIED. FOR EACH COVERED AUiO PREMIUM REM FIVE SCHEDULE FOR NON -OWNERSHIP LIABILITY NAMED INSURED'S BUSINESS I RAYING BASK I NUMM Plum Other than a Social Service en Number o o ea Num er or Partners Social Service Agency I Number of Employees Numbea of Volunteers; IN RETURN FOR THE PAYMENT OF THE PREMIUM, AND SUBJECT TO ALL THE TERMS OF THIS POLICY, WE AGREE WITH YOU TO PROVIDE THE INSURANCE AS STATED IN THIS POLICY. Premium shown is payable: $ l3, 946. 00 at inception. ENDORSEMENTS ATTACHED TO THIS POLICY: IL 00 2I-Broad form Nuclear Exclusion (Not applicable in New York) LOSS PAYEE COUNTERSIGNED BY (Date) Authorized Representative w5190 6IH 60DIM 310 (519W AIG6 3 OF 3 SF519DLD6 POLICY NUMBER: 60434-35-32 COMMERCIAL AUTO CA 20 49 02 99 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED INSURED This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM GARAGE COVERAGE FORM MOTOR CARRIER COVERAGE FORM TRUCKERS COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by this endorsement. This endorsement identifies person(s) or organization(s) who are "insureds' under the Who Is An Insured Provision of the Coverage Form. This a ndorsement does not after coverage provided in the Coverage Form. This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below. Endorsement Effective: Countersigned By: O1/23/15 Named Insured: WATERWISE LAND 9 WATERSCAPES Authorized Representative) SCHEDULE Name of Person(s) or Organization(s): CITY OF FORT COLLINS (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to the endorsement.) Each person or organization shown in the Schedule is an "insured" for Liability Coverage, but only to the extent that person or organization qualifies as an "insured" under the Who Is An Insured Provision contained in Section II of the Coverage Form. CA 20 48 02 99 Copyright, Insurance Services Office, Inc., 1998 Page 1 of 1 Policy Changes Endorsement Description VIN: 1FTM6G3NKA57I25 2005 FORD F350 SUPER VIN: IFI'W W31P25EB74832 2006 NUR UTL TRL VIN: 5M3BE162161018454 2003 VOLKSWAGEN JETTA GLS VIN: WVWSP61JX3W230578 2012 NISSAN NV 2500135 VIN: 1 N6AF0LXXCN 101255 2008 Pj DUMP Removal If Covered Property is removed to a new location that is described on this Policy Change, Permit you may extend this insurance to include that Covered Property at each location during the removal. Coverage at each location will apply in the proportion that the value at each location bears to the value of all Coveted Property being removed. This permit applies up to 10 days after the effective date of this Policy Change: after that, this insurance dos not apply a the previous location. U42n In ENFUM 7a2 Include (endAM,d Wbtl4t I.,s. WA,. Onn, 1. 00 d, P, RWIOP Pal t OF 2 RM401 Polcyy Changes Endorsement Description ADDITIONAL INSURED - CA20480299 ADDITIONAL INSURED-DESIGNATEI CITY OF FORT COLLINS PO BOX 580 FORT COLLINS, CO 80522 1999 FORD F350 VIN: IFBWF36S6XEB75266 1996 CHEVROLET K2500 V IN: 1 G CGK29R4TE259295 1992 FORD F250 Removal If Covered Property is removed to a new location that is described on this Policy Change, Permit you may mtend this insurance to include that Covered Property at each location during the removal. Coverage at each location will apply in the proportion that the value at each location bears to the value of all Covered Property being removed. This permit applies up to 10 days after the effective date of this Policy Change: after that, this insurance does not apply at the previous location. 91AM In MON TV Md. (Wi# d W,14 I... S,nke 0%, In, Ah is pnnb[m. ntnla IY[ Y Of 2 1417701 Polky Changes Endorsement Description ADD ADDITIONAL INTEREST ADDITIONAL INSURED-BP04480197 DESIGNATED PERSON OR ORGANIZATION CITY OF FORT COLLINS PO BOX 580 FORT COLLINS, CO 80522 LOCATION: 1121 N LEMAYAVE FORT COLLINS, CO 80524 ADD ADDITIONAL INTEREST Removal If Covered Property is removed to a new location that is described on this Policy Change, Permit you may wend this insurance to include that Covered Property at each location during the removal. Coverage at each location will apply in the proportion dw the value at each location bears to the value of all Covered Property being removed. This permit applies up to 10 days after the effective date of this Policy Change: after that, this insurance does not apply a the previous location. 714VI Ift Nlnnn 741 IndsW CWI M.d M.64 I... Sn". nNio, mc' -h rltrne PIG[ 1 OF 2 "W al THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ N CAREFULLY. Policy Number: 60434-35-32 POLICY CHANGES Effective Date of Change: 01/23/15 Expiration Daze: 12/01/15 Change Endorsemmt No.: 004 Agent: 07-08-348 Named Insured: WATERWISE LAND & WATERSCAPES 1121 N LEMAY AVE FORT COLLINS CO 80524 The following item(s): E4277 Isl Edition Insured's Name Insured's Mailing Address Policy Number Company Effective / Expiration Date Insured's Legal Stunts / Business of Insured Payment Plan Premium Determination X Additional Interested Parties Coverage Forms and Endorsements Limits / Fxposures Deductibles Covered Property / Location Description Classification / Class Codes Rates Underlying Insurance is (are) changed to read (See Additional Page(s)}: The above amendmmrs result in a change in the premium as follows: X No Chang. To Re Adjusted At Audit Additional Premium Return Premium Authorized Representative Signature: FARMERS INSURANCE 91421/ HTIOIOON 942 IN219101 PAU I OF 2 EN2MM THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. E4277 Policy Number: 60434-35-32 Effective Date of Change: 01/23/15 Expiration Datc 12/01/15 Change Endorsement No.: 004 Agent: 07-08-348 Named Insured: WATERWISE LAND & WATERSCAPES 1121 N L.EMAYAVE FORT COLLINS CO 80524 The following item(s): Insured's Name Insured's Mailing Address Policy Number Company Effective / Expiration Date Insured's Legal Status / Business of Insured Payment Plan Premium Determination X Additional Interested Parties Coverage Forms and Endorsements Limits / Exposures Dedtttribles Covered Property / Location Description Classification / Class Coda Rates Underlying Insurance is (ace) changed to read ISee Additional Page(s)j: The above amendments result in a change in the premium as follows: No Changes I I To Be Adjusted At Audit I Additional Premium I Return Premium Authorized Representative Signature: FARMERS INSURANCE 91aM 19010H 742 indudn(ggl9hedlMnk{Iwenm {eMmOIAm, Im, NhnpiMvm. Nt77101 FM I OF pm al THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ R CAREFULLY. Policy Number. 60434-35-32 POLICY CHANGES Effective Date of Change: 01/23/15 Expiration Date: 12/01/15 Change Endorsement No.: 004 Agent: 07-08-348 Named Insured: WATERWISE LAND & WATERSCAPES 1121 N LEMAY AVE FORT COLLINS CO 80524 The following item(s): E4277 Isl Edifln Insured's Name Insured's Mailing Address Policy Number Company Effective / Expiration Date Insured's legal Status / Business of Insured Payment Plan Premium Determination X Additional Interested Parties Coverage Forms and Endorsements Limits / Exposures Deductibles Covered Property / Location Description Classification / Class Codes Rates Underlying Insurance is (are) changed to read IS« Additional Page(s)}: The above amendments result in a change in the premium as follows: No Changes To Be Adjusted At Audit Additional Premium Return Premium _ a a Authorized Representative Signature FARMERS INSURANCE 914M IRERIIDN 10 RM10I PWI OF E4!/tD1 Policy Changes Endorsement Description VIN: 4P5D8142981122511 2003 GMC SIERRA K15 VIN: IGTGK13UO3F144369 2000ISUZU NPR VIN: JALC4B143Y7015446 2013 BETE VIN: 1B9TF2628DB663222 2001 FORD ECONOLINE VIN: 1FDSE34FIlHA64265 2001 ISUZU NQR Removal If Covered Property is removed to a new location that is described on this Policy Change, Permit you may extend this insurance to include that Covered Property at each location during the removal. Coverage at each location will apply in the proportion that the value at each location bears to the value of all Covered Property being removed. This permit applies up to 10 days after the effective date of this Policy Change: after that, this insurance does not apply at the previous location. 914177 In MON IV Wode (WigW vnmd IMO N 5MCH 0% Ice., 04 h Pm . 142UTU RW 2 OF 2 Eansnt THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ R CAREFULLY. Policy Number: 6043435-32 POLICY CHANGES Effective Date of Change: 01/23/15 Expiration Date: 12/01/15 Change Endorsement No, 004 Agent: 07-08-348 Named Insured: WATERWISE LAND & WATERSCAPES 1121 N LEMAY AVE FORT COLLINS CO 80524 The following item(s): E4277 Ist Edilion Insured's Name Insured's Mailing Address Policy Number Company Effective / Expiration Date Insured's Legal Status / Business of Insured Payment Plan Premium Determination X Additional Interested Parties Coverage Forms and Endorsements Limits / Exposures Deductibles Covered Property / Location Description Classification / Class Codes Rats Underlying Insurance is (arc) changed to read {See Additional Page(s)): The above amendments result in a change in the premium as follows: No Changes To Be Adjusted At Audit Additional Premium Return Premium Authorized Representative Signanue FARMERS INSURANCE 914M ISTtaINON Ztl[ I.M.(w4WHamm l-r.-S-,.s ONn, Im,"h[4111101 rtt[ I OF HZY1101