Loading...
HomeMy WebLinkAbout108976 L & M ENTERPRISES INC - INSURANCE CERTIFICATE (3)AC" ® 7DA.TE (MMIDDIYYYY) ��. CERTIFICATE OF LIABILITY INSURANCE /1e/2ole 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 endorsements . PRODUCER CONTACT Renee McReynolds NAME: Y Ewing -Leavitt Insurance Agency, Inc. PHONE0. (970) 679-7344 FVC No: (666)425-6180 4090 Clydesdale Parkway AIL ADDRESS:renee-mcreynolds@leavitt.com Suite 101 INSURERS AFFORDING COVERAGE NAIC # Loveland CO 80538 INSURERA:Selective Insurance Company 12572 INSURED INSURER B :Pinnacol Assurance 41190 L & M Enterprises, Inc. INSURER C : P O Box W INSURER D : 735 E . Highway 56 INSURER E : Berthoud CO 80513 INSURERF: CnVFRAr,FS rFRTIFIr ATF NIIIhARFR•1/1/19 ranPwal DCI1ICInKI Kit IIIADCD. 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 SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE F OCCUR EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED PREMISES Ea occurrence)$ 500,000 X MED EXP (Any one person) $ 15,000 Blanket WOS X S 2302880 2/1/2018 2/1/2019 x Blkt Addl Insureds PERSONAL BADVINJURY $ 1,000,000 GENT AGGREGATE LIMIT APPLIES PER: POLICY � JECOT- LOC GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP/OP AGG $ 2,000,000 $ OTHER: AUTOMOBILE LIABILITY COMBINED Ea ccidentSINGLE LIMIT a $ 1,000,000 X BODILY INJURY (Per person) $ A ANY AUTO ALL OS SCHEDULED AUTOS AUTOS X S 2302880 2/l/2018 2/l/2019 BODILY INJURY Per accident) ( $ x PROPERTY DAMAGE APer accident $ NON -OWNED HIRED AUTOS x AUTOS X $ Blkt WOS x Blkt Addl Insureds X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 5,000,000 AGGREGATE $ 5,000,000 A EXCESS LIAB CLAIMS -MADE DIED RETENTION $ S 2302880 2/l/2018 2/1/2019 B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECU I IVE OFFICER/MEMBEREXCLUDED? (Mandatory in NH) It L��cs, dcauibe under DESCRIPTION OF OPERATIONS below N/A incl Blanket Waiver of Subrogation 4188429 1/1/2019 1/1/2020 x PER OTH- STATUTE ER E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE - POLICY LIMIT $ 11000,000 A Contractors' Equipment S 2302680 2/1/2018 2/1/2019 Rented Equip $150,000 $1000 ded $1,000,000Installation Floater $1000 ded DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) re: BID 8095 Weed Cutting & Rubbish Removal; Certificate holder, its officers, agents and employees are named additional insured as respects both general and auto liability policies. The insurance evidenced by this certificate will not reduce coverage or limits and will not be cancelled except after thirty (30) days written notice has been received by the certificate holder. l.tK I It -ILA I t ML)LL)tK SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Fort Collins THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Attn: Purchasing Dept ACCORDANCE WITH THE POLICY PROVISIONS. P O Box 580 Fort Collins, CO 80522 AUTHORIZED REPRESENTATIVE R McReynolds/RESTEI�� ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD INgn7r torn Ani ,