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Home My WebLink About279796 COCAL LANDSCAPE - INSURANCE CERTIFICATE (3)A`C,OR�►a CERTIFICATE OF LIABILITY INSURANCE DATE (MM'DDIYYYY) 1/8/2019 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 have ADDITIONAL INSURED provisions or 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 CRS Insurance Brokerage 6600 E Hampden Ave Denver CO 80224 NOMW"' Sabrina Rahe PHoriE —_. ....... ._..__ ___ ________. 303-996 7834 a/c N :303-9967851 E MaNrati: IL ADDRESS: srahe@crsdenver.com INSURERS).AFFORDING COVERAGE NAIC # INSURER A: Westfield Insurance 24112 INSURED COCALAN-02 CoCal Landscape Services, Inc CoCal Landscape Construction Co. INSURER B: Pinnacol Assurance —__ iN_WLtERC., — 41190 — --„— 333 E 76th Ave INSURER 0 INSURER E, Denver CO 80229 INSURER F :. COVERAGES CERTIFICATE NUMBER:2057550142 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. "__,. AO R —_ -- POLICY NUMBER e� �MM IC YYYY MOLICYYY Y1 LIMITS tt R TYPEOF INSURANCE Man A X COMMERCIAL GENERAL LIABILITY A CLAIMS -MADE L X OCCUR Y I CMM014964C 1/1/2019 1/1/2020 EACH OCCURRENCE PREMISjE49,r@ ce $1,000,000 $500,000 X PD_Dad,$5,000 MED EXP (A one person) $ 5 000 X Pollution I [ PERSONAL & ADV INJURY $1 000,000 I GENERAL AGGREGATE PRODUCTS - COMPIOP AGG 'Pollution .. .._.__._. $ Z000 000� $ 2 000 000_._.__.. $Included._.. GEN'L AGGREGATE LIMIT APPLIES PER: POLICY X PRO- E] LOC i OTHER: A AUTOMOBILE LIABILITY Y CMM014984C 1!1/2019 1/1I2020 OMBINED SINGLE LIMIT 4Gde_n.__ $1,000,000 _ _ _X ANY AUTO BODILY INJURY (Per person) $µ OWNED j SCHEDULED 'AUTOS ONLY AUTOS HIRED NON -OWNED X AUTOS ONLY X AUTOS ONLY BODILY INJURY (Per accident) $ PROPERTY DAMAGE $ A X UMBRELLA LIAB 4x�r OCCUR CMM014964C 1/1/2019 1/1/2020 EACH OCCURRENCE $ 5,000,000 AGGREGATE $ 5,000,000 EXCESS LIAB I ; CLAIMS -MADE $ DED I XI RETENTION$ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANYPROPRIETORrPARTNER'EXECUTIVE YNN 4136357 1/1/2019 1/1/2020 iX i ,cPTATUTE URH E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE _.. $1,000,000 OFFICEWMEMBEREXCLUDED4 ❑INlA (Mandatory in NH) E.L. DISEASE - POLICY LIMIT $ 1,000,000 If yes. describe under DESCRIPTION OF OPERATIONS below I ji I DESCRIPTION OF OPERATIONS 1 LOCATIONS 1 VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required) "Herbicide/Pesticide Liability included City of Fort Collins, its officers, agents and employees are included as additional insured for ongoing and completed operations on the General Liability and included as additional insured on the Auto Liability with respect to operations of the named insured for the certificate holder as required by written contract. General Liability policy has been endorsed to provide 30 days notice of cancellation except 10-day notice for non-payment of premium. All policy terms, conditions and exclusions apply. PCOTIFif`ATG Nnl DRIP CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of Fort Collins P O Box 580 AUTHORIZED REPRESENTATIVE Fort Collins CO 80522 (01988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD 2 of 3 64 POLICY NUMBER: CMM014964C COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY, PESTICIDE OR HERBICIDE APPLICATOR - LIMITED POLLUTION COVERAGE This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Description Of Operations: LANDSCAPE GARDENING Information required to complete this Schedule, if not shown above, will be shown in the Declarations. 1. With respect to the operations shown in the Schedule, Paragraph (1)(d) of Exclusion I, of Sec- tion 1 - Coverage A - Bodily Injury And Property Damage Liability does not apply if the operations meet all standards of any statute, ordinance, reg- ulation or license requirement of any federal, state or local government which apply to those operations. Q Insurance Services Office, )nc , 2012 CG 22 64 04 13 3 of 3 64