HomeMy WebLinkAboutAMI MECHANICAL INC - INSURANCE CERTIFICATE (2)ACORL> CERTIFICATE OF LIABILITY INSURANCE
D 7/17/2019 VY)
7/17/2019
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 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
Commercial Risk Solutions
6600 E Hampden Ave Ste 200
Denver CO 80224
CONTANAME: CT Sabrina Rah@
PHONE FA%
303-996 7834 ac Ne:303-996-7851
ADDREEA'LSS: Sfahe crsdenvef.COm
INSURE S AFFORDING COVERAGE
NAIL#
INSURER A: Pinnacol Assurance
41190
INSURED AMIME-2
AMI Mechanical, Inc.
AMI Mechanical Systems, Inc.
INSURERS: United Fire Group
13021
INSURERC:
AMI Mechanical South
INSURERD:
12141 Pennsylvania Street
Thornton CO 80241-3115
INsuRERe:
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 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
TR OF INSURANCE
ADDLTYPE
INSD
SUER
WVD
POLICY NUMBER
MPOLICY
UD /YYYYYY
MIPOLICY DDDYYY
LIMITS
11
X
COMMERCIAL GENERAL LIABILITY
Y
60508862
10/1/2018
10/1/2019
EACH OCCURRENCE
$1,000,000
CLAIMS -MADE 1K OCCUR
PREMISES Ea occurrence
$1,000,000
MED EXP (Any one person)
$10,000
PERSONAL B ADV INJURY
$1,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
GENERAL AGGREGATE
$ 2.000,000
POLICY � JET LOC
PRODUCTS
$2,000,000
$
OTHER.
B
AUTOMOBILE LIABILITY
Y
60508862
10/1/2018
10/1/2019
COMBINEDSINGLE LIMIT
Ea accident
$1,000,000
BODILY INJURY (Per person)
$
X ANY AUTO
OWNED SCHEDULED
AUTOS ONLY AUTOS
BODILY INJURY (Per ecciderrt)
$
PROPERTY DAMAGE
Per ident
$
X HIRED X NON -OWNED
AUTOS ONLY AUTOS ONLY
B
UMBRELLA LIAR
X
OCCUR
60508862
10/1/2018
10/1/2019
EACH OCCURRENCE
$10,000,000
X
AGGREGATE
S 10,000.000
E%CESS LWB
CLAIMS -MADE
DED X RETENTION $n
$
A
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY Y I N
ANYPROPRIETOR/PARTNERIEXECUTIVE
4036338
10/1/2018
10/1/2019
X $T TOTE ER
E.L. EACH ACCIDENT
$ 1,000.000
OFFICER/MEMBER EXCLUDED? FN
NIA
(Mandatory in NH)
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 Leased/Rented Equipment
60508862
10/1/2018
10/1/2019
Limit
700,000
Special Form/RC
Deductible
1,000
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached 8 more space Is required)
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 & 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
AUTHORIZED REPRESENTATIVE
Fort Collins CO 80522
01988-2015 ACORD CORPORATION. All rights reserved.
ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD