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HomeMy WebLinkAbout165318 CMS MECHANICAL SERVICES INC - INSURANCE CERTIFICATE (5)i� CMSME-1 DATE 04/23/2019Y) 04/2312019 ACORO CERTIFICATE OF LIABILITY INSURANCE 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 endorsements . PRODUCER 970-482-7747 CONTACT Allison Heeren Brown 8: Brown Inc PHONE 970-482-7747 FAX 970-484-4165 4532 Boardwalk Dr, Suite 200 (A/C, No, Ext): (A/C, No): Fort Collins, CO 80525 E-MAIL . certificates@bbcolorado.com Tyler McCallister INSURE S AFFORDING COVERAGE NAIC # INSURER A:Depositors Insurance Company 42587 INSURED CMS Mechanical Services, Inc. INSURER B.. AMCO Insurance Company 19100 609 Technology Circle, Suite A Windsor, CO 80550 INSURER c : Pinnacol Assurance Company 41190 INSURER D : INSURER E : INSURER F : CCIVFRAr:FC CERTIFICATE NI IMRFR• RFVIRICIN NII IMRFR- 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 TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF 04/27/2019 POLICY EXP 04/27/2020 LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE E] OCCUR Y ACP3046558176 EACH OCCURRENCE 1,000,000 DAMAGE TO RENTED PREMISES $ 1 OO,000 MED EXP (Any oneperson) $ 10,000 PERSONAL BADVINJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY [X1 jpa7 F7 LOC OTHER. GENERAL AGGREGATE 2,000,006 PRODUCTS - COMP/OP AGG $ 2,000,000 A AUTOMOBILE LIABILITY X ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS SSW AUTOS ONLY AUTOS ONLDY Y ACP3046558176 04/27/2019 04/27/2020 COMBINED SINGLE LIMIT $ 1,000,000 BODILY INJURY Perperson) BODILY INJURY Per accident rr acEcRd.ntDAMAGE B X UMBRELLA LIAB EXCESSLIHB X OCCUR CLAIMS -MADE ACP3046668176 04/27/2019 04/27/2020 EACH OCCURRENCE 2,000,000 AGGREGATE 21000,000 DED I X I RETENTION $ 0 C WORKERAND EMPLOYERS' LIABILOITY COMPENSATINX ANY PROPRIETOR/PARTNER/EXECUTIVE XFICER/MEMBER EXCLUDED? u andatory in NH) If es, describe under DESCRIPTION OF OPERATIONS below NI A 4105092 06/01/2019 06/01/2020 PSTATUTEER ER OTH- E.L. EACH ACCIDENT 1,000,000 $ E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE - POLICY LIMIT 11000,000 A A Installation Fltr Lsd/Rntd Equip ACP3046558176 ACP3046558176 04/27/2019 04/27/2019 04/27/2020 Inst Fitr 04/27/2020 Lsd/Rtd 50,000 50,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space Is required) City of Fort Collins is included as an additional insured per forms and conditions on page 2. CITYFT5 City of Fort Collins Purchasing P. O. Box 580 Fort Collins, CO 80521 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 Tyler McCallister ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD CMSME-1 NOTEPAD INSURED'S NAME CMS Mechanical Services, Inc. OP ID: AH The following apply when required by written contract: GENERAL LIABILITY: Additional Insured On -going S Completed Operations CG7246 11/15 Primary/Non-Contributory Wording CG7246 11/15 Blanket Waiver of Subrogation CG7158 08/04 Per Project Aggregate CG2503 05/09 AUTOMOBILE LIABILITY: Additional Insured AC7005 (03/16) Blanket Waiver of Subrogation AC7005 (03/16) UMBRELLA LIABILITY: Following form WORKERS' COMPENSATION: Blanket Waiver of Subrogation 359-B Contractors Pollution:$1,000,000 Each Occurrence / $2,000,000 AGG The Contractor, Owners, Architect and the Architects consultants are included as Additional Insureds as .respect to Automobile Liability, the Gen Liability is primary 6 non- contributory only if required by written contract, the WC and General Liability policies include a Waiver of Subrogation in favor of the addl insureds only if required by written contract, and all are subject to the forms and conditions listed on page 2. PAGE 2 Date 04/23/2019