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HomeMy WebLinkAbout498970 HILL ENTERPRISES INC DBA HILL PETROLEUM - INSURANCE CERTIFICATE (8)Client#: 1513130 HILLENTI ACORD,. CERTIFICATE OF LIABILITY INSURANCE DATE(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 NAME: Julie King USI Insurance Services, LLC AIC No, El): 800 873-8500 A/c No): 303 831-5295 P.O. Box 7050 E-MAIL den.certificat ADDRESS: e@usi.com Englewood, CO 80155 800 873-8500 INSURER(S) AFFORDING COVERAGE NAIC # INSURER A : Philadelphia Indemnity Insurance Co. 18058 _ INSURED Hill Enterprises, Inc. dba INSURER 8 : Pinnaeol Assurance Company 41190 INSURER C:ToldoMarinsspecialty Insurance Co. 23850 Hill Petroleum INSURER D : 6301 W. 58th Avenue INSURER E: --- Arvada, CO 80002 INSURER F : GOVERAUES 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. �Tp TYPE OF INSURANCE ADDLSUBRO/LDID NSA WVD POLICY NUMBER F MM Millil EXP LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE 1 OCCUR PHPK1988844 D610112019 0610112020 $1 000 000 _ $100OOO pEACCHq�OECCCURRENCE PREMISES Eaoccumence MED EXP (Any one person) $ 0 PERSONAL & ADV INJURY _ $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: X POLICY ECOT- LOC OTHER: GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP/OP AGG $2,000,000 $ 1,000,000 $ A AUTOMOBILE X X LIABILITY ANY AUTO SCHED AUTOS ONLY AUTOSULED AUTOS ONLY X NON -OWNED AUTOS ONLY Drive Oth Car PHPK1988844 D6/01/2019 06/01/202 COMBEaacciderDitSINGLE LIMIT BODILY INJURY (Per person) BODILY INJURY (Per accident) $ $ PRO PER DAMAGE Per accident X $ A X UMBRELLA LIAB EXCESS LIAB I X I OCCUR CLAIMS -MADE PHUB678166 6/01/2019 06/01/2020 EACH OCCURRENCE $5000000 AGGREGATE $S OOO OOO DED I X I RETENTION $ 1 O 000 $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITYSIATUTE ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N OFFICER/MEMBEREXCLUDED? 7 If6es story In NH) DESCclescribe under RIPTION OF OPERATIONS below N/A 4148287 PPK1757999-1 6/01 /2019 06/01 /202 X PER oTH- E.L. EACH ACCIDENT $1 OOO O00 E.L. DISEASE - EA EMPLOYEE $1 000 000 E.L. DISEASE - POLICY LIMIT $1,000 OOO C Pollution 6/01/2019 06/01/201 $1,000,000 Occur/Aggre $50,000 Retention DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) I IrINM 1 C City of Fort Collins Financial SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Services, Purchasing Division ACCORDANCE WITH THE POLICY PROVISIONS. 215 N. Mason St., 2nd Floor P.O. Box 580 AUTHORIZED REPRESENTATIVE Fort Collins, CO 80522-0000 ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) 1 of 1 The ACORD name and logo are registered marks of ACORD #S25796537/M25794005 USBZP