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106253 SERVICEMASTER OF FORT COLLINS - INSURANCE CERTIFICATE
HSINC-1 PDATE(MMIDDfYYYY) 05/29/2019 ,4coRO CERTIFICATE OF LIABILITY INSURANCE 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 endorsements . PRODUCER 970-482-7747 Brown & Brown Inc 4532 Boardwalk Dr, Suite 200 Fort Collins, CO 80525 Karen E. Siwek, CPA c NTACT Karen E. Siwek, CPA PHO,NE 970-482-7747 FAX 970-484-4165 A/cNo, Ext : (AC, No E-MAIL ADDRESS: certi ICateS bbcolorado.com INSURERS AFFORDING COVERAGE NAIC # INSURER A:Plnnacol Assurance Company 41190 INSURED HS, Inc. dba ServiceMaster INSURER B : Capitol Specialty Insurance Co 10328 of Fort Collins dba ServiceMaster of Loveland dba ServiceMaster Solutions Westfield Insurance Company INSURER C: P Y 24112 INSURER D : Consolidated Programs Ins Sery 3054 Lake Canal Ct #120 Fort Collins, CO 80524 Philadelphia Indemnity Ins Co INSURER E : P tY 18058 INSURER F : CnVFRAnFR CFRTIFICATF NI IMRFR• RFVICIr1N NI IMRFR- 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 I TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXPLTR LIMITS B X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE F_X] OCCUR Pollution/Mold EV20191351-01 EV20191351-01 EV20191351-01 06/01/2019 06/01/2019 06/01/2019 06/01/2020 06/01/2020 06/01/2020 EACH OCCURRENCE $ 1,000,000 DAMAGESTO ( RENTED Ea occurrence) $ 50,000 X MED EXP (Any oneperson) $ 5,000 X CPUProfessional PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRO- X POLICY JECT LOC OTHER: GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP/OP AGG 2,000,000 $ C AUTOMOBILE LIABILITY ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS AUTOS ONLY L A�TOS ONLY CWP6099227 06/01/2019 06/01/2020 COMBINED SINGLE LIMIT (Ea acQidpol)X $ 1,000,000 BODILY INJURY Perperson) $ BODILY INJURY Per accident $ PROPERTY DAMAGE Per accident $ $ D X UMBRELLA LAB EXCESS LIAB X_ OCCUR CLAIMS -MADE EX20191352-01 06/01/2019 06/01/2020 EACH OCCURRENCE $ 2,000,000 AGGREGATE $ 2,000,000 DED I X RETENTION $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/RIEMBEP. EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N /A 4166362 06/01/2019 06/0112020 X PER I OTH- TER E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE - POLICY LIMIT 1,000,000 C E Lease/Rent Equip Cyber Liab CWP6099227 PHSD1447382 06/01/2019 06/01/2019 06/01/2020 06/01/2020 Limit Limit 25,000 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) CITYOFF City of Ft. Collins 215 N Mason St 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 Karen E. Siwek, CPA ACORD 25 (2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD No Text