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Home My WebLink AboutHILLSIDE CONSTRUCTION - INSURANCE CERTIFICATEACORN® CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DDYVYY) 03/22/2019 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 Kylie Carey, CISR. CIC NAME: Flood and Peterson PHONE (g70) 266-7148 FAX (970) 506-6845 A/C No Ext : A/C, No PO Box 578 E-MAIL KCarey@floodpeterson.com ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # Greeley CO 80632 INSURER A : Employers Mutual Casualty Company 21415 INSURED INSURER B: EMCASCO Insurance Company 21407 Hillside Construction, Inc. INSURER c : Travelers Property Casualty Company ofAmerica 25674 216 Hemlock Street, Suite B INSURER D : Pinnacol Assurance 41190 INSURERE: Indian Harbor Insurance Company ?6940 Fort Collins CO 80524 INSURER F : COVERAGES CERTIFICATE NUMBER: FnGrtW/Frt/f1olx4/1/20 REVISION Nl1MRFR- 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 ADULSUBIR INSD WVD POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DD/YYYY LIMITS X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE FX OCCUR EACH OCCURRENCE 1,000,000 S DAMAGE TRENTED PREMISES Ea cc ourrence $ 1001000 MED EXP (Any one person) $ 5,000 PERSONAL B ADV INJURY $ 1,000,000 A 6DO1591 04/01/2019 04/01/2020 GEN'LAGGREGATE LIMITAPPLIES PER. POLICY PRO ❑ JECT LOC GENERAL AGGREGATE $ 2,000,000 PRODUCTS $ 2,000,000 $ OTHER. AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ 1,000,000 X BODILY INJURY (Per person) $ ANYAUTO B SCHEDULED AUTOS 6EO1591 04/01/2019 04/01/2020 BODILY INJURY (Per accident) $ X X NON -OWNED ONLY PROPERTY DAMAGEAUTOS Per accidentUnderinsured motorist s 1,000,000 2NLY AB HCLAIMS-MADE OCCUR """'V""` "'�""""'10,000,000 EACH OCCURRENCE $C ZUP41M9358319NF 04/01/2019 04/01/2020 AGGREGATE $ 10,000,000 ETENTION $ 10,000 D WORKERS COMPENSATION AND EMPLOYERS' LIABILITY AINYPRCPRIeTOR;PARrNER/EXECUTdC Yj �� OFFICER/MEMBER EXCLUDED? L'� (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N/A 4147214 04/O1/2019 04/01/2020 X STATUTE EORH EL EACH ACCIDENT 1,000000 E.L. DISEASE - EA EMPLOYEE S 1,000,000 E.L. DISEASE - POLICY LIMIT $ 1,000,OOD E Prof. &Poll. Liability PECO04563504 04/01/2019 04/01/2020 $2,000,000/$2,000,000 S25,000 SIR DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) l.CR 1Iri AtC r1ULUGR t AN1_t:LLAI IUN City of Fort Collins P.O. Box 580 Fort Collins CO 80522-0580 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 (2016103) The ACORD name and logo are registered marks of ACORD