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HomeMy WebLinkAbout117224 HORIZON MECHANICAL SOLUTIONS - INSURANCE CERTIFICATE (4)Ap�®
CO I` CERTIFICATE OF LIABILITY INSURANCE
DATE (MM/DDIYYYY)
I
`..+'
03/11/2019
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 Shannon Kammerer
NAME:
Flood and Peterson
A/CNNo Ext : (970) 356-0123� No): (970) 330-1867
E-MAIL SKammerer@floodpeterson.com
ADDRESS:
PO Box 578
INSURER(S) AFFORDING COVERAGE
NAIC #
INSURER A: Acadia Insurance Company
31325
Greeley CO 80632
INSURED
INSURER 8 : Plnnacol Assurance
41190
INSURER C :
Horizon Mechanical Solutions
INSURER D :
Dba Horizon Sheet Metal, Inc
INSURER E
126 Hemlock Street
INSURER F
Fort Collins CO 80524
COVERAGES CERTIFICATE NUMBER: x4/1/19-20 Master 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 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
5UBR
WVD
POLICY NUMBER
POLICY EFF
MM/DD
POLICY EXP
MMIDDIYYYY
LIMITS
COMMERCIAL GENERAL LIABILITY
EACH OCCURRENCE
$ 1,000,000
CLAIMS -MADE ® OCCUR
DAMAGE TO RENTEff_
PREMISES Ea occurrence
$ 300,000
MED EXP (Any one person)
$ 5,000
PERSONAL BADVINJURY
$ 1,000,000
A
CPA3128697-23
04/01/2019
04/01/2020
GEN'L AGGREGATE LIMIT APPLIES PER:
GENERAL AGGREGATE
$ 2,000,000
POLICY © JECT ❑ LOC
PRODUCTS - COMP/OP AGG
$ 21000,000
Employee Benefits
$ 1,000,000
OTHER:
AUTOMOBILE LIABILITY
COMBINED SINGLE LIMIT
(Ea accident
$ 1,000,000
BODILY INJURY (Per person)
$
ANYAUTO
A
OWNED SCHEDULED
AUTOS ONLY AUTOS
CPA3128697-23
04/01/2019
04/01/2020
BODILY INJURY (Per accident)
$
PROPERTY DAMAGE
Per accident
$
HIRED NON -OWNED
AUTOS ONLY AUTOS ONLY
Medical payments
$ 5,000
UMBRELLA LIAB
X
OCCUR
EACH OCCURRENCE
$ 5,000,000
AGGREGATE
$ 5,000,000
A
EXCESS LIAB
CLAIMS -MADE
CPA3128697-23
04/01/2019
04/01/2020
DED I X RETENTION $ 0
s
B
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY y / N
ANY PROPRIETOR/PARTNER/EXECUTIVE Y
OFFICERIMEMBER EXCLUDED?
(Mandatory In NH)
NIA
4009379
04/01/2019
04/01/2020
X STATUTE ERH
E.L. EACH ACCIDENT
1 ,000,000
$
E.L. DISEASE - EA EMPLOYEE
$ 1,000,000
if yes, describe under
DESCRIPTION OF OPERATIONS below
E.L. DISEASE - POLICY LIMIT
1,000,000
$
DESCRIPTION OF OPERATIONS I LOCATIONS ! VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required)
Certificate holder is included as Additional Insured as required by written contract with respects to liability arising out of work performed by the named
insured.
[yaC411201i\ I a:C41g1gV
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
City of Fort Collins ACCORDANCE WITH THE POLICY PROVISIONS.
P.O. BOX 580
AUTHORIZED REPRESENTATIVE
Fort Collins CO 80522 li/ /W b Ar�/irMeA_..-
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