HomeMy WebLinkAboutMISTER B'S HVAC INC - INSURANCE CERTIFICATEA(� �® CERTIFICATE OF LIABILITY INSURANCE
DA 0/10602019 YI
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 corder rights to the certificate holder In lieu of such endarsement s .
PRODUCER
FEDERATED MUTUAL INSURANCE COMPANY
HOME OFFICE: P.O. BOX 328
NAMTIICT CLIENT CONTACT CENTER
IAI.PHONE.N. Fat , 888-3334949 Fn c No ; 507-646-G664
ADDRESS: CLIENTCONTACTCENTER FEDINS.COM
OWATONNA, MN 55060
INSURI I AFFORDING COVERAGE
NAIC #
_
INSURER A: FEDERATED MUTUAL INSURANCE COMPANY
13935
INSURED 342-538-6
INSURER B:
MISTER B'S HVAC INC
INSURER C:
PO BOX 21756
INSURER D:
CHEYENNE, WY 82003-7045
INSURER E:
INSURER F:
COVERAGES CERTIFICATE NUMBER: 49 REVISION NUMBER: 0
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
DL
INSR
SUBR
WLD
POLICY NUMBER
POLICY EFF
MMIDDIVYYY
POLICY EXP
MMIDDIYYYY
LIMITS
A
COMMERGAL GENERAL LIABILITY
CLAIMS -MADE ❑X OCCUR
BUSINESS OWNER'S LIABILITY
N
N
9246994
09/08/2019
D9/08/2020
EACH OCCURRENCE
$1,000,000
DAMAGE TO RENTEDPREMISES (E. nored)
$100,000
X
MED EXP (Any one person)
G
X
PERSONAL& ADV INJURY
$1,000,000
N'L AOGRIIG UMIT APPLIES PER:
POLICY LJECT 1:1LOC
OTHER:
GENERAL AGGREGATE
$2,000,000
PRODUCTS- COMPIOP ADD
$2,000.000
q
I AUTOMOBILE LIABILITY
I X ANY "TO
~� SCHEDULED
owHED alms ONLY �I AUTOS
HIRED AUTOS ONLY NOWOWNEO
AUTOS ONLY
N
N
9246985
09/08/2019
09/08/2020
COMBINED SINGLE UNIT
ff,ecel en
$1,000,ODO
BODILY INJURY IPer Person)
BODILY INJURY IPe, emWanQ
PROPERTY DAMAGE
- en
A
X
UMBRELLA LIAR X OCCUR
EXCESS LIAR CLAIMS -MADE
N
N
9246SB6
09/08/2019
09/08/2020
EACH OCCURRENCE
$1,000,ODC
AGGREOATE
$1,000,000
I DED RETENTION
A
AND EMPLOYERS' LIABILITY Y!
MY PROPRIETORIPARTNERIEXECUTIVE
OFFICER/MEMBER EXCLUDED'
IMaMAWry in NMI
IT yea, describe under
DESCRIPTION OF OPERATIONS below
NIA
N
9246984
09/08/2019
09/08/2020
PER STATUTE ER
E.L EACH ACCIDENT
$1,000,000
E.L. DISEASE- EA EMPLOYEE
$1,000,ODO
E.L DISEASE POLICY LIMIT
$1,000,000
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101. AddibWnl Rewouts SO,edule, may W aeeoadd It more apeee is relpdred)
STOP -GAP (EMPLOYER'S LIABILITY) COVERED STATE(S) WV
342-53"
CITY OF FORT COLLINS
PO BOX 580
FORT COLLINS, CO 80522-0580
490
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 1G
441
m 198R-2015 ACORD CORPORATION. All rights reserved
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