HomeMy WebLinkAboutAMI MECHANICAL INC - INSURANCE CERTIFICATEACROF CERTIFICATE OF LIABILITY INSURANCE DATE(MMiOD/YYVV)
;/1712019
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 CONTCT
NAME, Sabrina Rahe
Commercial Risk Solutions PHONE 303 996 7834 ac No). 303-996-7851
6600 E Hampden Ave Ste 200 E-MAIL
Denver CO 80224 : srahe crsdenver.com
INSURED AMIME-2
AMI Mechanical, Inc.
AMI Mechanical Systems, Inc.
AMI Mechanical South
12141 Pennsylvania Street
Thornton CO 80241-3115
INSURERA: Pinnacol Assurance
41190
INSURERS: United Fire Group
13021
INSURERC:
INSURER o:
INSURER E:
INSURER F :
COVERAGES CERTIFICATE NUMBER:498049518 REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERI00
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.
_ D
- - . .._
ILTH TYPEOFINSURANCE POUCYNUMBER MWD E� IAAIIDIC nYYP LMM
B
GENERAL LUIBIL"
Y
! 60508862
10/1/2018
10/1/2019
EACH OCCURRENCE
$1.000.000
TOERCIAL
CLAIMS -MADE FTI OCCUR
DAMAGE TO RENTED
PREMISES Ea occurrence
$1,000,000
MED EXP lAny one person)
$10,000
PERSONAL & ADV INJURY
$ 1,000,000
GEN'L
AGGREGATE LIMIT APPLIES PER:
GENERAL AGGREGATE
$2,000,000
�
POLICY I " I JEST LOC
PRODUCTS - COIAP/OP AGO
52,000,000
9
OTHER:
B
AUTOMOBILE
_
Y
80508862
10/1/2D18
10/1/2019
CCMBINED SINGLE LIMIT
Ea accident)
$1.000.000
BODILY INJURY (Par person)
$
X ANY AUTO
OWNED SCHEDULED
AUTOS ONLY AUTOS
ar BODILY INJURY (Paccident)
S
PROPERTY DAMAGE
Par accident
y
X HIRED X NON -OWNED
IAUTOS ONLY AUTOS ONLY
$
B
UMBRELLAUA13
X
OCCUR
60508862
10/12018
10/1/2019
EACHOCCURRENCE
S10.000,000
X
AGGREGATE
E 10,000,000
EXCESS UAB
CLAIMS -MADE
DEC X I RETENTIONS
S
A WORKERS COMPENSATION 4036338
AND EMPLOYERS' LIABILITY Y / N
ANYPROPRIETOR;PARTNER/EXECUTIVE
10112018
10/12019
X STATUTE ER
E.L. EACH ACCIDENT
$1,000.000
OFFICERIMEMBEREXCLUDED? NIA
(Mandatory In NII)
E.L. DISEASE - EA EMPLOYEE
E 1,000,000
E.L. DISEASE - POLICY LIMIT
81,0D0,000
II yes, describe under
DESCRIPTION OF OPERATIONS below
8 LeasedlRemed Equipment 60508862 10/12o18
Special FormIRC
10/12019
Lime
Deductible
700,coo
1,000
DESCRIPTION OF OPERATIONS I LOCATIONS r VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is requited)
City of Fort Collins, its officers, agents and employees are included as additional insured for ongoing and completed operations on the General Liability and
included as additional insured on the Auto Liability with respect to operations of the named insured for the certificate holder as required by written contract. All
policy terms, conditions 8 exclusions apply.
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
City of Fort Collins
P.O. Box 580
Fort Collins CO 80522
AUTHORIZED REPRESENTATIVE
a ,,r ,
Alf
01988-2015 ACORD CORPORATION. All rights reserved.
ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD
2 of 12 80