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304369 CONTINENTAL HARDSCAPE SYSEMS INC - INSURANCE CERTIFICATE
AC ORO� CERTIFICATE OF LIABILITY INSURANCE DATE (MWDD/YYYY) oslzs/zols 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 Bnanne Danielson, CISR NAME: Flood and Peterson PHONE (970)266-7118 FAX (970)506-6846 A/C No Ext : A/C No); Corporate Mailing Address. E-MAIL s: BDanielson@FloodPeterson.com ADDRE INSURER(S) AFFORDING COVERAGE NAIC p P.O. Box 578 Greeley CO 80632 INSURER A: Westfield Insurance Company 24112 INSURED INSURER B : PinnaCol Assurance 41190 INSURER C : Continental Hardscape Systems, LLC INSURER D : 2200 E. 104th Avenue INSURER E : Suite 201 INSURERF: Thornton CO 60233 COVERAGES CERTIFICATE NUMBER: CL1962630004 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE 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 INSD WV POUCYNUMBER POLICY EFF MM/DD/YYYY) POLICY EXP (MMIDDIYYYYL LIMITS x COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE E 1,000,000 CLAIMS -MADE LZ OCCUR A A'T PREMy ES Ea oocurrence E 500,000 MED EXP (Any one person) E 5,000 PERSONAL BADV INJURY E 1,000,000 A CWP1817099 07/17/2019 07/17/2020 GEN'LAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE E 2,000,000 POLICY ® ECOT 0 LOC PRODUCTS -COMP/OPAGG E 2,000,000 E OTHER. AUTOMOBILE LIABILITY COMBINEDSINGLE LIMIT Ea accident S 1,000,000 BODILY INJURY Per person) E ANY AUTO A OWNED SCHEDULED CWP1817099 07/17I2019 07/17I2020 BODILY INJURY Peraccident)accident) E AUTOS ONLY AUTOS PROPERTYDAMAGE S HIRED NON -OWNED AUTOS ONLY AUTOS ONLY Per aecitlent Medical payments E 5,000 X UMBRELLA LIAB X OCCUR EACH OCCURRENCE E 5,000,000 AGGREGATE S 5,000,000 A EXCESS LIAB CLAIMS -MADE CWP1817099 07/17/2019 07/17/2020 DED %� RETENTION E 0 E WORKERS COMPENSATION X AND EMPLOYERS' LIABILITY Y I N STATUTE ERH E.L EACH ACCIDENT E 1,000,000 B ANY PROPRIETOR/PARTNER/EXECUTIVE FYI NIA 4179574 01/01/2019 01/01/2020 1,000,000 OFFICER/MEMBEREXCLUDED? (Mandatory In NH) E.L. DISEASE - EA EMPLOYEE E If yes. describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT E 1,000,000 Leased/Rented Equipment A CWP1817099 07/17/2019 07/17l2020 Limit 50,000 Deductible Soo DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached H more space Is required) City of Fort Collins is listed as an Additional Insured as their interest may appear as respects General Liability, for ongoing operations only. Insurance is primary and noncontributory. CERTIFICATE HOLDER 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. P.O. Box 580 AUTHORIZED REPRESENTATIVE Fort Collins CO 80525 73tLQJIX[ �,n IP,LSorv. ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD