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Home My WebLink About498970 HILL ENTERPRISES INC DBA HILL PETROLEUM - INSURANCE CERTIFICATE (7)Client#: 1513130 HILLENTI ACORDT. CERTIFICATE OF LIABILITY INSURANCE FEATE(MM/DD/YYYY) 5/31 /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 any rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: .tulle King U I Insurance Services, LLC PHONE o Ext, 800 873-8500 A/C No): 303 831-5295 P.O. Box 7050 EI -ADDRESS: den.certificate@usi.com Englewood, CO 80155 800 873-8500 INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: Philadelphia Indemnity Insurance Co. 18058 INSURED INSURER B : Pinnacol Assurance Company 41190 Hill Enterprises, Inc. dba 23850 Tokio Marine specialty Insurance Hill Petroleum INSURER C: co. 6301 W. 58th Avenue INSURER D : Arvada, CO 80002 INSURER E : INSURER F : 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 CONTRACTOR 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 INSR SUBR WVD POLICY NUMBER POLICY EFF POLICY EXP MM/DD/YYYY MM/DD/YYY LIMBS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR PHPK1988844 6/01/2019 06/01/2020 EAACCH�OECCCURRENCE $1 OOOOOO _ $100000 PREMISES EaoccuErence MED EXP (Any one person) so PERSONAL & ADV INJURY $1 000,000 $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: X POLICY ECOT- LOC OTHER: GENERAL AGGREGATE PRODUCTS - COMP/OP AGG $ 2,000,000 $ A AUTOMOBILE LIABILITY ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS HIRES ONLY X NON -OWNED AUTOS ONLY Drive Oth Car PHPK1988844 06/01/2019:06/01/2020 COMBINED SINGLE LIMIT Ea accident)1,000,000 X X BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ $ PROPERTY DAMAGE Per accident X $ A X UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE PHUB678166 6/01/2019 06/01/2020 EACH OCCURRENCE $5 000 000 $5 00O 000 $ AGGREGATE DED I X RETENTION $ 1 O 000 B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y / N OFFICER/MEMBER EXCLUDED? � (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N/A 4148287 6/01/2019 _ 6/01/2019 06/01/20 X PER OTH- E.L. EACH ACCIDENT $1 000 000 E.L. DISEASE - EA EMPLOYEE $1 000 000 E.L. DISEASE - POLICY LIMIT $12000 000 C Pollution PPK1757999-1 06/01/2020 $1,000,000 Occur/Aggre $50,000 Retention DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If morespaee Is required) Pl ail II11IPy_II MEi City of Fort Collins Purchasing Department P.O. Box 580 Fort Collins, CO 80522-0000 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 (2016/03) 1 of 1 #S25796538/M25794005 01988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD USBZP