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Home My WebLink AboutHAHN PLUMBING AND HEATING INC - INSURANCE CERTIFICATE (2)ACOR�� CERTIFICATE OF LIABILITY INSURANCE �- FDATE(MWDD/YYYY) 6/26/2019 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 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 Karole Peters Ewing -Leavitt Insurance Agency, Inc. xt: (970) 679-7355 p/C, NO; (866)237-2178 4090 Clydesdale Parkway karole-petersOleavitt.com FADDRESS: Suite 101 INSURER(S) AFFORDING COVERAGE NAIC a A: Acuity A Mutual Insurance Company 14184 Loveland CO 80538 INSURED INSURER B : Pinnacol Assurance 41190 Hahn Plumbing and Heating Inc. INSURER C: P 0 Box 1924 INSURER D INSURER E Fort Collins CO 80522 INSURERF: COVERAGES CERTIFICATE NUMBER:19-20 ALL 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 AODL SUBR POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DD/YYVY LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE X OCCUR ZB0205 7/1/2019 7/1/2020 EACH OCCURRENCE $ 1,000,000 DA A T ERENToED PREMISES a ccurrence $ 250,000 X MED EXP (Any one person) $ 10,000 Blkt Additional Insured X Blkt Waiver of Subro PERSONAL & ADV INJURY $ Included GEN'LAGGREGATE LIMIT APPLIES PER : POLICY PRO- � ECT 71 LOC GENERAL AGGREGATE $ 3,000,000 PRODUCTS - COMP/OPAGG $ 3,000,000 $ OTHER: A AUTOMOBILE LIABILITY ZB0205 7/1/2019 7/1/2020 COMBINED SINGLE LIMIT Ea accident $ 1,000,000 X BODILY INJURY (Per person) $ ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS (Per accident ( ) BODILY INJURY P $ HIRED AUTOS X NON -OWNED AUTOS X PROPERTY DAMAGE Per accident $ X $ Blkt Al X BIkt WOS A UMBRELLA LIAB X OCCUR ZB0205 7/1/2019 7/1/2020 EACH OCCURRENCE $ 1,000,000 4DED AGGREGATE $ 1,000,000 EXCESS LIAR CLAIMS -MADE RETENTION $ $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y❑ OFFICER/MEMBER EXCLUDED? N / A 4059219 Blanket Waiver of Subrogation 7/1/2019 7/1/2020 X SPER TATUTE EORH E.L. EACH ACCIDENT $ 500,000 E.L. DISEASE - EA EMPLOYEE $ 500,000 (Mandatory in NH) If yes, describe under Included E.L. DISEASE -POLICY LIMIT $ 5001000 DESCRIPTION OF OPERATIONS below A Contactors' Equipment ZB0205 7/1/2019 7/1/2020 Installation Floater $50,000 Leasec/Rented Equipment $ 50 , 0 0 0 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION City of Fort Collins Utilities Dept. ATTN: Amber DeNooy P.O. Box 580 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 role Peters/KAPETE K" *V,> 4 l ACORD 25 (2014/01) INS025 (201401) U 1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD