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HomeMy WebLinkAbout110001 HIGH PLAINS MECHANICAL SERVICE INC - INSURANCE CERTIFICATE (2)ACOR"' CERTIFICATE OF LIABILITY INSURANCE 16...1 4/1/2020 DATE(MM/DD/YYYY) 3/22/2019 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 Lockton Companies 444 W. 47th Street, Suite 900 Kansas City MO 64112-1906 (816) 960-9000 CONTACT NAME: ArcNE, No, Ext : AX Na E-MAIL ADDRESS: INSURERS AFFORDING COVERAGE NAIC # INSURER A: XL Insurance America Inc. 24554 INSURED High Plains Mechanical Service, Inc. 130480, 2020 Airway Avenue Fort Collins CO 80524 INSURER B : Great American Insurance Company 16691 INSURER C INSURER D : INSURER E : INSURER F COVERAGES CERTIFICATE NUMBER: 14908463 REVISION NUMBER: XXXXXXX 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 INSD SUER WVD POLICY NUMBER POLICY EFF MM/DDIYYYY POLICY EXP MMIDD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR Ex Y N RGD3001475 4/1/2019 4/1/2020 EACH OCCURRENCE 1,000,000 DAMAGE TO RENTED PREMISES Ea occurrence 300,000 MED EXP (Any oneperson)1 O OOO PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PECOT- LOC OTHER: GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP/OP AGG $ 2,000,000 $ A AUTOMOBILE LIABILITY ANY AUTO OWNED TOS ONLY AUTOSSCHED ONLY NON-OWNED TSONE N Y N RAD9437964 4/1/2019 4/1/2020 COBINEDtSINGLE LIMIT $ 2000000 X BODILY INJURY (Per person) $ XXXXXXX BODILY INJURY (Per accident $ XXXXXXX X perde OacntDAMAGEAUTOS $ XXXXXXX $XXXXXXX B X UMBRELLA LIAR EXCESS LIAB OCCUR N N TUU0189267-09 4/1/2019 4/1/2020 EACH OCCURRENCE $ 25 000 000 NCLAJMS-MADE AGGREGATE $ 25,000,000 DED RETENTION $ $ XXXXXXX A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY OFFICER/MEMBER/ EXCLUDED ECUTIVE N❑ (Mandatory in NH) If yes. describe under DESCRIPTION OF OPERATIONS below N / A N RWD3001476 4/1/2019 4/1/2020 TH- X STATUTE DER E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE 1,000,000 E.L. DISEASE - POLICY LIMIT 4 1.000.000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) THE CITY, ITS OFFICERS, AGENTS AND EMPLOYEES ARE ADDITIONAL INSURED WITH RESPECT TO THE GENERAL LIABILITY AND AUTOMOBILE LIABILITY COVERAGE, ONLY AS REQUIRED BY WRITTEN CONTRACT, SUBJECT TO THE TERMS AND CONDITIONS OF THE POLICY. I.tK 1 It-II.A I t r1VLUCK I.AIVI.CLLA 1 IVIV 14908463 FORT COLLINS WATER PRODUCTION 4316 LAPORTE AVE. 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 ACORD 76 t2n1R/nm 0)1gk-2015 ACORD CORPORATION- All rinht5 reserved The ACORD name and logo are registered marks of ACORD