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HomeMy WebLinkAbout462834 FOOTHILLS LANDSCAPE MAINTENANCE LLC - INSURANCE CERTIFICATE (2)oR>o® CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 3/15/2019 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 UUNIAUT NAME: Paula Blohm Madison Insurance Group PHONEFA AJC No Ell: 3033220800 (AIC, No): 3033220874 It MAIL ADDRESS: pblohmCmadisoninsurance.net 600 South Cherry St, Ste 900 INSURER(S) AFFORDING COVERAGE NAIC # Denver CO 80246 INSURER A : NATIONWIDE INSURANCE 23787 INSURED INSURER B : TRAVELERS INSURANCE 19046 INSURER C : PINNACOL ASSURANCE 41190 Foothills Landscape Maintenance, LLC INSURER D : CENTRAL MUT INS CO 20230 Po Box 189 INSURER E : INSURER F : Windsor CO 80550 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, LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER (MMIDDIYYYYI (MM/DDNYYY) LIMITS A X COMMERCIAL GENERAL LIABILITY OCCUR Y I ACP3027035176 04/01/2019 04/01/2020 EACH OCCURRENCE $ 1,000,000 —7CLAIMS-MADE AM PREMISES (Ea occurrence) $ 100,000 MED EXP (Any one person) $ 5,000 PERSONAL &ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: RO- POLICY �X JE LOC OTHER: GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP/OP AGG $ 2,000,000 $ D AUTOMOBILE LIABILITY ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED AUTOS ONLY X AUTOS ONLY BAP99137797 04/01/2019 04/01/2020 (Ea accident) $ 1,000,000 X BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ X HNUHEK I Y JAMAUL (Per accident) $ B X UMBRELLA LIAB EXCESS LIAB )( OCCUR CLAIMS -MADE ZLJP-91M95774-18-NF 04/01/2019 04/01/2020 EACH OCCURRENCE $ 2,000,000 AGGREGATE $ 2,000,000 DED RETENTION $ $ C ORKERS COMPENSATION ND EMPLOYERS' LIABILITY Y / N NY PROPRIETOR/PARTNER/EXECUTIVE FFICER/MEMBER EXCLUDED? Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N / A 4154852 04/01/2019 04/01/2020 X I STATUTE ER E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE - POLICY LIMIT $ 1,000,000 A Contractors Equipment ACP CIM 3027035176 04/01/2019 04/01/2020 Scheduled Equipment Leased/Rented Limit Deductible $299,600 $100,000 $1,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) The certificate holder is included as an additional insured in regards to the General Liability policy per written contract. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Fort Collins ACCORDANCE WITH THE POLICY PROVISIONS. PO Box 580 AUTHORIZED REPRESENTATIVE Fort Collins, CO 80522 pa-44L, $myµ,. ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD