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HomeMy WebLinkAbout120528 FORT COLLINS TREE CARE INC - INSURANCE CERTIFICATE (7)FORTCOL-09 PDEAVER ,a►coRJT7 CERTIFICATE OF LIABILITY INSURANCE DATE/VYYY) 3/24/2 D4/2015 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 TrueNorth PO Box 847 Longmont, CO 80502 INSURED Fort Collins Tree Care, Inc 301 East Douglas Road Fort Collins. CO 80524 " r"`' I Pat Deaver NAME: I re",°NW ESN• (303) 776-5122 /F. E Not. (303) 7765495 INSURER A: Twin City Fire Insurance Company 129459 T INSURER R . Pinnacol Assurance Comoanv 141190 INSURER D : E II1.T3:7=I1 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. I"S LTR TYPE OF INSURANCE POLICYNUMBER POLICY EFF MM/DD/YY POLICY EXP MM/DD LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE a OCCUR AGGREGATE LIMIT APPLIES PER: POLICY —I PRO- JECT LOC OTHER. 34UUNSR3900 03I05/2015 03/05/2016 EACH OCCURRENCE $ 1,000, DAMAGE TO RENTEU PREMISES Ea occurrence $ 300,00 MED EXP (Any one person) S 10,0 PERSONAL & ADV INJURY § 1,000,0 GEML GENERAL AGGREGATE $ 2,000,0011 PRODUCTS - COMP/OP AGG $ 2,000,00 $ A AUTOMOBILE LIABILITY X ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS X X NON -OWNED HIRED AUTOS AUTOS 34UUNSR3900 03/05/2015 03/05/2016 CEOeMBBII EDD SINGLE LIMIT $ 1,000,00 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE Par acciderd S S UMBRELLA LIAR EXCESS U AB OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DED I I RETENTION$ $ B WORKERS COMPENSATION AND EMPLOYERS LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE YIN OFFICER/MEMBER EXCLUDED? (Mandatory in NH) IF yes, describe under DESCRIPTION OF OPERATIONS below NIA 4148327 05/01/2015 05J01/2016 X PER TH- STATUTE ER E.L. EACH ACCIDENT $ 100,00 E.L. DISEASE - EA EMPLOY $ 100,00 E.L. DISEASE - POLICY LIMIT I $ 600,00 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space Is required) City of Fort Collins as Additional Insured as required by written contract per General Liability policy form. CERTIFICATE HOLDER CANCELLATION City of Fort Collins Purchasing Division P O Box 580 Fort Collins, 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. AUTHORIZED REPRESENTATIVE tM $A 0' N e © 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD