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HomeMy WebLinkAbout462834 FOOTHILLS LANDSCAPE MAINTENANCE LLC - INSURANCE CERTIFICATEFHLAN-1 OP ID: JD ACo/2O CERTIFICATE OF LIABILITY INSURANCE DATE 03/31120131/2015 5 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 Brown & Brown Inc 1,532 Boardwalk Dr, Suite 200 =ort Collins, CO 80525 INSURED Maintenance, LLC P. O. Box 189 Windsor, CO 80550-0189 I( NAME: I Tyler B. Allen 1 FAX Pear N. F-,,.970-482-7747ONE F: e_ N.,. 970-484-4165 A:Pinnacol Assurance Company B: Ohio Security Insurance Co. C :Owners Insurance Company n , National Union Fire Insurance COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: 190 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. NSR LTR TYPE OF INSURANCE POLICY NUMBER MMIDDIYYYY MMIDD/YYYY LIMITS B X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 CLAIMS -MADE [X] OCCUR X BKS1555942531 04/01/2014 05/01/2015 PREMISES Ea =nce $ 300,00 MED EXP (Any one person) $ 15,00 PERSONAL &ADV INJURY $ 1,000,00 GEML AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $ 2,000,00 - POLICY a EEC LOC PRODUCTS-COMP/OP AGG $ 2,000,00 $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ee accident $ 1,000,00 BODILY INJURY (Per person) $ C X ANY AUTO X 76969100 04/01/2014 05/0112015 ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ PROPERTYDAMAGE Per aaidenl $ X X NON -OWNED HIRED AUTOS AUTOS UMBRELLA LI O X OCCUR EACH OCCURRENCE $ 2,000,00 -XI AGGREGATE $ 2,000,00 D EXCESSLIAB CWMS-MADE BU061234937 04101/2014 0510112015 DED X RETENTION$ 0 $ WORKERS COMPENSATION AND EMPLOYERS LIABILITY A ANY PROPRIETOR/PARTNERIEXECUTIVE YMIA OFFICERIMEMBER EXCLUDED?Fill (Mandatory in NH) 154$52 04/01/2015 04101/2016 X STATUTE EORTR E.LEACHACCIDENT $ 1,000,00 E.L. DISEASE- EA EMPLOYE $ 1,000,00 H yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - PODGY UMIT $ 1,000,00 B Leased/Rented BKS1555942531 04/01/2014 05101/2015 Limit 50,000 Equipment Ded 1,000 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space Is required) The certificate holder is included as an additional insured per forms and conditions shown on page 2. CiTYFC2 City of Fort Collins PO 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 �->k`—wa%'-9� ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (20141?01) The ACORD name and logo are registered marks of ACORD No Text