HomeMy WebLinkAbout165318 CMS MECHANICAL SERVICES INC - INSURANCE CERTIFICATE (6)CMSME-1 OP ID:
ACORO CERTIFICATE OF LIABILITY INSURANCE DATE ATUM/Y
s/1 z/2o19
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 endorsements .
PRODUCER 970-482-7747 CONTACT Allison Heeren
NAME'
Brown 8 Brown Inc PHONEo 970482-7747 Pia�.970.484-4165
Fort Boardwalk Dr, Suite 200 -MAIL , ce cateS beo Ora o.com
Fort Collins, CO 80525 D
Tyler McCallister aecnnrwr_'w,eear_e uer s
INSURED CMS Mechanical Services, Inc.
609 Technology Circle, Suite A
Windsor, CO 80550
Assurance
COVERAGES CERTIFICAT NI IMBER: REVISION NUMBER:
9100
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
TYPE OF INSURANCE
ADDIL
INCIMA
SU
POLICY NUMBER POLICY EFF
POLICY EXP
LIMITS
X
COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE ❑ OCCUR
Y
CP3046558176 04/27/2019
04/27/2020
EACH OCCURRENCE
1,000,00O
DAMAGE TO RENTED
PREMISES I
$ 100,000
MED EXP A one Person)$
10,000
PERSONAL B ADV INJURY
1,000,000
GENL AGGREGATE pLIMIT APPLIES PER:
POLICY JECT LOC
OTHER:
GENERAL AGGREGATE
$ 2,000'wo
PRODUCTS -COMPIOP AGG
21000,000
A
AUTOMOBILE LIABILITY
X ANY AUTO
OWNED SCHEOULED
AUTOS ONLY AUUT'OpSyy��p
AUTOS ONLY AUTOS ONLY
y
P3046568176
04/27/2019
04/2712020
COMBINED SINGLE LIMIT
udsn
1,000,000
BODILY INJURY Per arson
BODILY INJURY Per accident)
PR�OPEREerrt MAGE
PPEACH
B X
UMBRELLA LUM
EXCESS LWB
X
OCCUR
CLAIMS -MADE
ACP3046558176
04/2712019
04/27/2020
OCCURRENCE
2,000'000
AGGREGATE
S 21000,000
DEO I X I RETENTION $
C WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY
ANY PROPRIETOR/PARTNER/EXECUTIVE YIN
IFFICERIM INR EXCLUDED?
(Mandatory In NH)
If yes, describe under
DESCRIPTION OF OPERATIONS 221m
N/A
219329
09/10/2019,
09/01/2020
X PER R
EL EACH ACCIDENT
$ 11000'000
E.L. DISEASE - EA EMPLOYEE
$ 1,000,006
E L DISEASE -LICY LIMIT
1,000,000
A Installation Fltr
A Lsd/Rntd Equip
P3046558176
FCP3046558176
041272019
04/27/2019
04/27/2020
04/27/2020
Inst Fitr 50,000
Lsd/Rtd 100,000
DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Addltlonal Remarks Schedule, may be attached If more space is requlrWl
City of Fort Collins is included as an additional insured per forms and
conditions on page 2. 30 day notice of cancellation applies.
CITYFT5
City of Fort Collins
Purchasing
P. 0. Box 580
Fort Collins, CO 80521
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
Tyler McCallister
ACORD 25 (2016/03) V 1988-1U1b AGLJKU taJKrvKAI IUN. An ngnts reserveu.
The ACORD name and logo are registered marks of ACORD