HomeMy WebLinkAbout543031 BC SERVICES INC - INSURANCE CERTIFICATEDATE(MMM&YYYY)
,4c�oRn® CERTIFICATE OF LIABILITY INSURANCEF3/20/2019
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 CONTACT
NAME: RM Longmont
TrueNorth Companies, L.C. PHONE Fax
275 5 Main Street Suite 100 . 303-776-5122 Arc No , 303-776-5495
Longmont CO 80501 Ao AIESS: Lon montSM truenorthcom anies.com
INSURER{_ AFFORDING COVERAGE NAIC #
INSURER A: West American Insurance Company 44393
INSURED BCSERVI-01
Bc Services, Inc, Boettcher Family, Llc 1NS_urtERe: Ohio Secu�_Insurance Company 24082
m
P O Box 1317 INSURERC: The Ohio Casualty Insurance Coan _ 24074
Longmont CO 80502 INS~o: Pinnecol Assurance 41190
INSURER E
i
INSURER F :
rtnvFRer:Fc r6ZQTIFIr ATF NIIMRFR-1R1nRRR17R RFVISION 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.
` POLICY EFF POLICY EXP
INSRT TYPE OF INSURANCE POLICY NUMBER MM.�DDrYYYY MMO YY LIMITS
LTR
A
X COMMERCIAL GENERAL LIABILITY
I
BKW57687740
3/24/2019
3/24/2020
EACH OCCURRENCE
$1,000,000
CLAIMS -MADE OCCUR
$100.000
ENfEti nc—
PR 1 �nee)
MED EXP (Any one rson)
$15,000
PERSONAL & ADV INJURY
$
GEN'L AGGREGATE LIMIT APPLIES PER:
GENERAL AGGREGATE
$ 2,000,D00
PRO-
X POLICY JECT L_— LOC
PRODUCTS - COMP/OP AGG
$ 2.000,000
$
.: OTHER.
B
AUTOMOBILE LIABILITY
BA557687740
3J24/2019
3/24/2020
COMBINED SINGLE LIMIT
$1 000 ODO
BODILY INJURY (Per person)
$
ANY AUTO
OWNED SCHEDULED
AUTOS ONLY AUTOS
X HIRED X NON -OWNED
AUTOS ONLY AUTOS ONLY
BODILY INJURY (Per accident)
$
PROPERTY DAMAGE
$
C
X UMBRELLA LIAR X OCCUR
US057687740
3/24/2019
3/24/2020
EACH OCCURRENCE
$ 5,000M000
AGGREGATE
EXCESS
_L CLAIMS -MADE
$ 5,000,DW
_
rD
�LIA•B—
DED II X I RETENTION $ in nnn
$
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY Y r N
ANYPROPRIETORIPARTNER/EXECUTIVE
( OFFICER/MEMBER EXCLUDED')
(Mandatory In NH)
NIA
516892
7/1/2018
7/1/2019
ER
IX PT T
$100,000
I E.L.EA�T
y
E.L. DISEASE - EA EMPLOYEE
$100,000
H yes. describe under
DESCRIPTION OF OPERATIONS below
E.L. DISEASE - POLICY LIMIT
$ 500,000
I
DESCRIPTION OF OPERATIONS; LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached It more space Is required)
Certificate Holder is Additional Insured as their interest may appear in operations of the Named Insured on their behalf, as required by written contract, with
respect to General Liability
r+ro-rlcer`ATc un1 nco CANCFI I ATInN
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
PO Box 580
Fort Collins CO 80522
AUTHORIZED REPRESENTATIVE
U 1988-2015 ACORD CORPORATION. All rights reserved.
ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD
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