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HomeMy WebLinkAbout120528 FORT COLLINS TREE CARE INC - INSURANCE CERTIFICATE (10)OD ACOR" CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDDIYYYY) 1 `,� 2/22/2019 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. 275 S. Main Street, Ste. 100 '!ONE 303-776-5122 �- a/c No): 303 776 5495 E-MAIL ADDRESS: certs@truenorthcompanies.com Longmont CO 80501 _ INSUR ERI S) AFFORDING COVERAGE _ NAIC # INSURER A: Pinnacol Assurance Company i 41190 INSURED FORTCOL-09 Hartford Accident and Indemnity COmpany_J 2235_7 INSURERB Y Fort Collins Tree Care, Inc. �- -- ----- 301 East Douglas Road -MSURER Q _Trumbull Insurance Compan ry _ 27120 Fort Collins CO 80524 INSURER 0: INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER:986022672 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. Abfi4' ( POLI(MMOpYEXIP ILTR TYPEOF INSURANCE POLICY NUMBER MPOLICY-EFF LIMBS B ,X, COMMERCIAL GENERAL LIABILITY Y 34UUNSR3900 3/5/2019 3l5/2020 EACH OCCURRENCE $11000,000 �X OCCUR 300,000 ;CLAIMS -MADE P�E_MI$5.(Ezt occurrence) $ DEXP (ArI� __ one�..erson) � ME __ .-,_..._ .$.10_ 000 x i PEST/HERB• AT PERSONAL & ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE �W „ $ 2,000,000 PRO LOC POLICY X� JE PRODUCTS - COMP/OP AGG $ 2 000 000 OTHER: ! *LTD POLLUTION $ INCLUDED C AUTOMOBILE LIABILITY i 1 34UENOK7387 3/5/2019 3/5/2020 COMBINED SINGLE LIMIT $1,000,000 BODILY INJURY (Per person) �$ }( ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS I $ BODILY INJURY (Per accident) X HIRED x _ PgaccdenDAMAGE - $ AUTOS ONLY AO OS ONLDY UMBRELLA LIAB H OCCUR I EACH OCCURRENCE _____ $ AGGREGATE ____ $ EXCESS LIAR CLAIMS_MADE DED_ RETENTION $ A WORKERS COMPENSATION 4148327 5/1/2018 5/1/2019 X PER OTH- AND EMPLOYERS' LIABILITY YIN ANYPROPRIETOR/PARTNER/EXECUTIVE i E.L. EACH ACCIDENT $1,000,000 jOFFICEMMEMBEREXCLUDED? NIA E.L. DISEASE - EA EMPLOYEE $1,000,000 j (Mandatory In NH) If Yes describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE • POLICY LIMIT 1 $1,000,000 i DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule. may be attached it more space is required) City of Fort Collins as Additional Insured as required by written contract. n I It-IUA I t HUL City of Fort Collins Purchasing Division P O Box 580 Fort Collins CO 80522 USA 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 ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD 2 of 2 198