HomeMy WebLinkAboutSOILOGIC INC - INSURANCE CERTIFICATEACOCERTIFICATE OF LIABILITY INSURANCE
DAT /19I2019 Y)
04/19/R"
019
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 Jordan Hartman, CISR
NAME:
Flood and Peterson
PHONE (g70) 356-0123 FAX (970) 330-1867
A/C No C, No): Ext : A/
PO Box 578
E-MAIL JHartman@floodpeterson.com
ADDRESS:
INSURER(S) AFFORDING COVERAGE
NAIC #
Greeley CO 80632
INSURER A : Pinnacol Assurance
41190
INSURED
INSURER B : Everest Indemnity Insurance Co.
10851
SOIIogic, Inc.
INSURER C :
3522 Draft Horse Court
INSURER D :
INSURER E :
Loveland CO 80538
INSURER F :
COVERAGES CERTIFICATE NUMBER: CL1941928681 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 MAYBE 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.
LTR
TYPE OF INSURANCE
INSD
WVD
POLICY NUMBER
MM/DDY/YYYY
EXP
MM DDEFFY/YYYY
LIMITS
COMMERCIAL GENERAL LIABILITY
EACH OCCURRENCE
$
CLAIMS -MADE 7OCCURMAUt
A
PREMISES (Ea occurrence)
$
MED EXP (Any one person)
$
PERSONAL 8ADVINJURY
$
GEN'LAGGREGATE LIMITAPPLIES PER:
GENERAL AGGREGATE
$
POLICY ❑ PRO LOC
JECT
PRODUCTS -COMP/OP AGG
$
$
OTHER
AUTOMOBILE
LIABILITY
COMBINED SINGLE LIMIT
(Ea accident)
$
BODILY INJURY (Per person)
$
ANYAUTO
OWNEDONLY AUTOS SCHEDULED
AUTOS
BODILY INJURY (Per accident)
$
HIRED NON -OWNED
AUTOS ONLY AUTOS ONLY
PROPERTY DAMAGE
(Per accident
$
UMBRELLA LIAB
OCCUR
EACH OCCURRENCE
$
AGGREGATE
$
EXCESS LIAB
CLAIMS -MADE
DED RETENTION $
$
A
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY Y / N
ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFIC tort' in BER EXCLUDED?
(Mandatory in NH)
N/A
4093786
06/01/2018
06/01/2019
X1 STATUTE EORH
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
B
Professional Liability
PLE000091-181
04/20/2018
05/20/2019
Occurrence/Aggregate
1/2,000,000
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
VCr[1 IrIVHIC r1VLUCR
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.
300 LaPorte Ave.
AUTHORIZED REPRESENTATIVE
Fort Collins CO 80521
@ 1988-2015 ACORD CORPORATION. All rights reserved.
ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD