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Home My WebLink AboutHIGH COUNTRY PIPE AND UTILITY INC - INSURANCE CERTIFICATEA.C"RD® _../ CERTIFICATE OF LIABILITY INSURANCE DATE (MM/201 9 f) 01/03/2019 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 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 Ben Parsons State Farm Agency stateFarm 2121 Midpoint Dr Unit 301A Fort Collins, CO 80525 Ow CONTACT JudyDavis NAME: PHOIC,NE 970-484-3600 aC Ne :970-672-8704 ADDRIESS:ludy@bensinsurance.com INSURER(S) AFFORDING COVERAGE NAIC # INSURER A :State Farm Fire and Casualty Company 25143 INSURED High Country Pipe and Utility Inc 1211 Midway Dr Fort Collins, CO 80526 INSURER B :State Farm Mutual Automobile Insurance Company 25178 INSURER C: INSURERD: INSURER E: INSURER F : 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. INSR LTR TYPE OF INSURANCE ADDL 1 SUBR POLICY NUMBER POLICY EFF MMiDDIYYYY POLICY EXP MWDD LIMITS A X COMMERCIAL GENERAL LIABILITY Y Y EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE IS] OCCUR ED PREMISES Ea occurrence $ 300,000 MED EXP (Any one person) $ 5,000 96 CG-M770.4 01/06/2019 01/06/2020 PERSONAL & ADV INJURY $ 1 ,000,0m GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY ❑PRO- ❑ LOC JECT PRODUCTS - COMP/OP AGG $ 2,000,000 $ 10,000 OTHER: B AUTOMOBILE LIABILITY Y Y CMBINED Ee accidentSINGLE LIMIT $ 1,000,000 /� ANY AUTO BODILY INJURY (Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS NON -OWNED HIRED AUTOS AUTOS 4018017-AO6-06-001 01/06/2019 07/06/2019 BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ $ A X UMBRELLA LIAB OCCUR 96-CL-Q361-1 03/09/2018 03/09/2019 OCCURRENCE EACH OCCURRENCE $ 1,000,000 $EACH AGGREGATE $ 2,000,000 EXCESS LIAR CLAIMS -MADE DIED RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N PER OTH- STATUTESTTUTE ER E.L. EACH ACCIDENT .. $ ANY PROPRIETOR/PARTNERIEXECUTIVE OFFICER/MEMBER EXCLUDED? ❑ N / A E.L. DISEASE - EA EMPLOYEE $ (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ A Inland Marine Mobile Equipment Policy 96-CL-K892-1 10/19/2018 10/19/2019 $58,000 DESCRIPTION OF OPERATIONS / LOCATIONS 1 VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION The City of Fort Collins PO Box 850 Fort Collins, Colorado 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 1988-2&14 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD 1001486 132849.9 02-04-2014