HomeMy WebLinkAboutPHILLIPS PLUMBING AND MECHANICAL INC - INSURANCE CERTIFICATE (2)AFRO® CERTIFICATE OF LIABILITY INSURANCE
DATE (MM/2019 Y)
D7/3D/D,9
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 Dana Stewart, CIC,CISR
NAME:
Flood and Peterson
PHONE
o Exit, (970) 266-7149 FAX No), (970) 506-6845
No,
PO Box 578
E-MAIL ADDRESS: DStewart@floodpeterson.com
INSURER(S) AFFORDING COVERAGE
NAIC4
Greeley CO 80632
INSURER A: Charter Oak Fire Insurance Company
25615
INSURED
INSURERS: Travelers Property Casualty Company of America
25674
INSURERC: Pinnacol Assurance
41190
Phillips Plumbing And Mechanical, Inc.
INSURDER
217 Versaw Court
INSURER E :
1INSURERF:
Berthoud CO 80513
Cr1VFRAr:FS CERTIFICATE Nt1MBER GL/AU/WCIXS x81112020 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
IN
POLICYNUMBER
MW
MM/D
LIMITS
A
COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE � OCCUR
DT-CO-1 L672870-COF-1 9
08/01/2019
08/01/2020
EACH OCCURRENCE
$ 1,000,000
PREMISES Ea accurrence
$ 300,000
MED EXP (Arty one person)
$ 10,000
PERSONAL& ADV INJURY
$ 1,000,000
GENLAGGREGATE LIMIT APPLIES PER:
POLICY ® JET LOC
OTHER:
GENERALAGGREGATE
$ 2,000,000
PRODUCTS-COMP/OPAGG
$ 2,000,000
$
A
AUTOMOBILE LIABILITY
ANY AUTO
OWNED SCHEDULED
AUTOS ONLY AUTOS
X HIRED NON -OWNED
AUTOS ONLY AUTOS ONLY
810-1 L655928-19-26-G
08/01I2019
08101/2020
COMBINED SINGLE LIMIT
Ea accident
$ 1,000,000
BODILY INJURY (Per person)
$
BODILY INJURY (Per acciaccident)$
PROPERTY DAMAGE
Per accident
$
E
B
x
UMBRELLAUAB
EXCESSLIAB
OCCUR
CLAIMS -MADE
ZUP-91NO1905-19-NF
08/01/2019
08/01/2020
EACH OCCURRENCE
$ 9,000,000
AGGREGATE
$ 9,000,000
DED I X RETENTION $ 10,000
$
C
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY YIN
ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICER/MEMBER EXCLUDED?
(Mandatory In Nil)
I' yes, desc'be under
DESCRIPTION OF OPERATIONS below
NIA
4059628
08/01/2019
08/01/2020
ER
X STATUTE ERH
EL EACH ACCIDENT
$ 1,000,000
EL. DISEASE - EA EMPLOYEE
$ 1,000,000
E.L. DISEASE - POLICY LIMIT
E 1, 000,000
DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more apace Is required)
r FRTIFICATF HOI r)FR CANCELLATION
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.
PO Box 580
AUTHORIZED REPRESENTATIVE
Ft Collins CO 80522
C 1988-2015 ACORD CORPORATION. All rights reserved.
ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD