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HomeMy WebLinkAbout124948 TOP GUN PRESSURE WASHING INC - INSURANCE CERTIFICATE (18),aco0 CERTIFICATE OF LIABILITY INSURANCE 76/28/2MM1DDtYYYY) 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 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 NAME: Olson & Olson Ltd PHONE FAX 5655 S. Yosemite St. #200 Arc No Ext : 303-867-2055 AC. c No): 303-867-2074 Greenwood Village CO 80111 ADDRESS: o2@olsonandolson.com INSURED Top Gun Pressure Washing, Inc. 500 W. 67th St. Loveland CO 80538 INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: Pinnacol Assurance 41190 TOPGU-1 INSURERS: American Select Insurance 19992 INSURER C : INSURER D : f`A\fFDAf_FC f'FDTIGIr ATF MI IMRFR• Al 1')0rA'1 RFVISInN NIIMRFR- 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. INSRPOLICY EFF POLICY EXP I-TR TYPE OF INSURANCE ADDL UBR POLICY NUMBER MM/DD/YYYY MMI D/YYYY LIMA LT B GENERAL LIABILITY TRA6418137 7/1/2019 7/1/2020 EACH OCCURRENCE $1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED PREMISES Ea occurrence $100,000 CLAIMS -MADE Fi-I OCCUR MED EXP (Any one person) $10,000 PERSONAL & ADV INJURY $1,000,000 GENERAL AGGREGATE $ 2,000,000 ��EN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2,000,000 $ POLICY X PRO- LOC B AUTOMOBILE LIABILITY TRA6418137 7/1/2019 7/1/2020 COMBINED SINGLE LIMIT Ea accident $1,000,000 BODILY INJURY (Per person) $ X ANY AUTO BODILY INJURY (Per accident) $ ALL OWNED SCHEDULED AUTOS AUTOS NON -OWNED X HIRED AUTOS X AUTOS PROPERTY DAMAGE Per accident $ B X UMBRELLA LIAR X OCCUR TRA6413137 7/1/2019 7/1/2020 EACH OCCURRENCE $ 5,=000 AGGREGATE $ 5,D00,000 EXCESS LIAB CLAIMS -MADE DIED I X I RETENTION $ N/A $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? ❑Y N I A 4031609 7/1r2019 7/1/2020 X WC STATU- O R IM LI E.L. EACH ACCIDENT $ 1,000,000 (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE $1,000,000 E.L. DISEASE - POLICY LIMIT $1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space Is required) Certificate Holder and those listed below (if any) are Additional Insureds as respects General Liability and Umbrella Liability on a Primary and Non -Contributory basis, and Auto Liability only if required by written contract or agreement and coverage applies only as respects work performed by the Insured for the Additional Insureds. All coverage terms, conditions, and exclusions of the policy apply. The Worker's Compensation, General Liability, Auto Liability, and Umbrella Liability policies include a Waiver of Subrogation in favor of the Additional Insureds only if required by written contract or agreement. Contract Work. Additional Insured(s): The City, its officers, agents and employees. CERTIFICATE HOLDER CANCELLATION City of Fort Collins Purchasing Department; Attn: John Stevens 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 © 1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD