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279796 COCAL LANDSCAPE - INSURANCE CERTIFICATE (4)
a CERTIFICATE OF LIABILITY INSURANCE DATE( $(2Q19VYY) 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 CONTACT Sabrina Rahe CRS Insurance Brokerage PHONEFAX 6600 E Hampden Ave - 303-996 7834 arc No:303-9967851 L s: srahe crsdenver.com Denver CO 80224 INSURER(Sj AFFORDING COVERAGE INSURER A : Westfield Insurance 24112 INSURED COCALAN-02 — INSURER B : Plnnacol Assurance 41190 CoCal Landscape Services, Inc __._._ ___ __.. CoCal Landscape Construction Co. INSURERC: INSURER 0 : 333 E 76th Ave Denver CO 80229 INSURER E, INSURER F : COVERAGES CERTIFICATE NUMBER:1452434761 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. �M POLICY EFF POLICY EXP_ INSf1TJ `- �._.�... ;ADOL SUS LTR . TYPE OF INSURANCE wvnPOLICY NUMBER MMIDBJYYYY MM/D /YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY CMM014964C 1/1/2019 1 1/1/2020 EACH OCCURRENCE $1,000,D00 CLAIMS -MADE X OCCUR AT�fA("i`T itENiC1 Pii MI S-1 a_gccurrgrlceee) 5 _ $ 00,000 X ! PE) Ded-$5,000 MED EXP (Ary onejareon) $ 5 000 Pollutbn _ _..___� _ PERSONAL & AOV INJURY _ $ 1,000,000 _ GEN'L AGGREGATE LIMIT APPLIES PER: POLICY X j jE LOC GENERAL AGGREGATE_ $2,000,000 PRODUCTS -COMP/OP AGG $ Z,000,000 OTHER: I Ponutbn $ Included A AUTOMOBILE LIABILITY CMM014964C 1/1/2019 1/1/2020 OMBINEO SINGLELIMIT $1,000,000 BODILY INJURY (Per person) $ X ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS X HIRED X NON -OWNED AUTOS ONLY AUTOS ONLY BODILY INJURY (Per accident) $ i PROPERTYOAMAGE ; (P—gr�5cidgry(j f $ $ A X !; uMBREuauae X 1OCCUR EXCESS LIAB i _ __.1�. CLAIMS -MADE DED X RETENTION$n CMM014964C 1/1/2019 1/1/2020 EACH OCCURRENCE _ AGGREGATE _ $5,000,D00_ _ $ 5,000,000 $ B WORKERS AND EMPLOYOMPENSATION ERS' LIABILITY YIN ANYPROPRIETOR/PARTNE ''EXECUTIVE ❑N OFFICER/MEMBEREXCLUC (Mandatory In NH) INIA 413t3357 1/1/2019 1/1 /2020 x.., PER A U' E.L EACH A_C_CIDENT _..$1000,000 E.L.DISEASE EA EMPLOYEE $1,000,000 If yes. describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT I ....______�__ _ $ 1,000,000 I 1 DESCRIPTION OF OPERATIONS 1 LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space Is required) I-IUA I t "VLUt:h 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 ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD 2of3 65 POLICY NUMBER: CMM014964C .T 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, With respect to the operations shown in the Schedule, Paragraph (1)(d) of Exclusion f, of Sec- tion I - 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, Ga Insurance Services Office, M , 2012 CG 22 64 04 13 3 of 3 65