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HomeMy WebLinkAbout110001 HIGH PLAINS MECHANICAL SERVICE INC - INSURANCE CERTIFICATE (3)ACOR"' CERTIFICATE OF LIABILITY INSURANCE 16-� 4/1/2020 DATE(MMIDDIYYYY) 1 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 NAME: NE FAX A/c, No, EXt : A/C, No): E-MAIL ADDRESS: INSURERS AFFORDING COVERAGE NAIC # INSURER A: XL Insurance America Inc. 24554 INSURED High Plains Mechanical Service, Inc. 1398315 2020 Airway Avenue Fort Collins CO 80524 wsURER B : Great American Insurance Company 16691 INSURER C : Zurich American Insurance Company 16535 INSURER D : Steadfast Insurance Company 26387 INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: 13545069 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 SUBR WVD POLICY NUMBER POLICY EFF MMIDDIYYYY POLICY EXP MM/DD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY Y Y RGD3001475 4/1/2019 4/1/2020 EACH OCCURRENCE 1,000,000 DAMAGE REM PREMISES (Ea TO RENTED ) $ 300,000 CLAIMS -MADE � OCCUR MED EXP (Any oneperson) 10,000 PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER. POLICY JE� LOC GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP/OP AGG $ 2,000,000 $ OTHER: A AUTOMOBILE LIABILITY Y Y RAD9437964 4/1/2019 4/l/2020 aBINEDtSINGLE LIMIT (Ea $ 2,000, OOO X BODILY INJURY (Per person) $ XXXXXXX ANY AUTO AAUTOS ONLY SCHEDULED BODILY INJURY (Per accident $ XXXXXXX PROPERTY DAMAGE Per accident $XXXXXXX HIRED NON -OWNED AUTOS ONLY AUTOS ONLY $XXXXXXX B UMBRELLA LIAB X OCCUR N N T000189267-09 4/I/2019 4/1/2020 EACH OCCURRENCE $ 25000000 rl AGGREGATE $ 25,000,000 EXCESS LIAB CLAIMS -MADE DIED RETENTION $ $ XXXXXXX A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) N / A Y R WD3001476 4/1/2019 4,/1 /2020 X STATUTE OER CH ACCIDENT $ 1,000,000 LEDEASE - EA EMPLOYEE 1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT s 1,000,000 D POLL/PROF LIABILITY N N E005833423-07 4/1/2019 4/1/2020 $10,000,000OCC/AGG C INSTALLATION FLTR CPP 4886518-09 4/1/2019 4/l/2020 $1,500,000 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) CITY OF FORT COLLINS IS AN ADDITIONAL INSURED WITH RESPECT TO THE GENERAL AND AUTO LIABILITY COVERAGE, WHICH IS PRIMARY COVERAGE TO THE ADDITIONAL INSURED AND OTHER AVAILABLE INSURANCE WILL BE NON-CONTRIBUTORY AS REQUIRED BY CONTRACT. SUBROGATION RIGHTS ARE WAIVED IN FAVOR OF THE CERTIFICATE HOLDER AS REQUIRED BY CONTRACT AND WHERE ALLOWED BY LAW. CERTIFICATE HOLDER CANCELLATION 13545069 CITY OF FORT COLLINS 215 N MASON ST PO BOX 580 FORT COLLINS CO 80522 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 25 (2016/031 ' _Z'4 ©1 8-2015 ACORD CORPORATION. All rights reserved The ACORD name and logo are registered marks of ACORD