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HomeMy WebLinkAbout124948 TOP GUN PRESSURE WASHING LLC - INSURANCE CERTIFICATE (3)®Ro CERTIFICATE OF LIABILITY INSURANCE 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 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 NAME: ", Olson &.Olson Ltd PHONE 5655 S. Yosemite St. #200 fAIC. No.E.xth 303-867-2055 Greenwood Village CO 80111 nooeess: Certificates ols INSURED TOPGU-1 Top Gun Pressure Washing, LLC 500 W. 67th St. Loveland CO 80538 COVERAGES THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN BELOW HAVE BEEN ISSUED TO THE I NSU RED NAMED ABOVE FOR THE POLICY PERIOD OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR TYPE OF. INSURANCE im2mAD L UBR .ROUCY.NUMBER MMODY/YYYY MM/DD//YYYY LIMITS A GENERALLIABILJTY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE J OCCUR 323 CPA5676 - 3/4Y2020 � 314Y2021 EACH OCCURRENCE $1,000,000 DAMAGETO RENTD PREMISES Ea occurrence $ 560,000 MED EXP (Any one person) $10,000 PERSONAL& ADV INJURY $1,WO,ODO GENERAL AGGREGATE - $2,000,000 GENT AGGREGATE LIMIT APPLIES PER: POLICY r X PRO jEC� n LOC PRODUCTS - COMP/OP AGG $ 2,D00,000 $ A AUTOMOBILE LIABILITY ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS HIRED AUTOS NON -OWNED AUTOS CP4323W6 3/4t2620 3/4/2021 COMBINED SINGLE LIMIT Ea accident 1,000 000 X BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ A X UMBRELLA LJAB EXCESS LIAB X OCCUR CLAIMS -MADE CPA323W* 3/4/2020 3/42021 EACH OCCURRENCE $ 10,000,000 AGGREGATE $ 10,000,000 DED I X RETENTION $ WA Is C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y LNPARTNER/EX. OFFICER/MEANY IM66R1EXCLUDED? ECUTIVE (Mandatory Ln NH) Ifyes, describe under DESCRIPTION OF OPERATIONS below N /A 4031609 7/1/2020 7112021 X WC STATU- OTH- E.L. EACH ACCIDENT $1,000;000 E.L. DISEASE - EA EMPLOYE $1,D00,000 E.L. DISEASE -POLICY LIMIT $ 1,000.000 B Excess Liability NHAO89286 3/42020 3/42021 Each Occurrence 5,000,000 Aggregate 5.000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101,IAdditional See Attached... Remarks Schedule, if more apace Is required) City of Fort Collins Purchasing Department; Attn: John P.O. Box 580 Fort Collins CO 80522-0580 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. AUTHORIZED REPRESENTATIVE ©1988-2010 ACORD CORPORATION-. All rights reserved. ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: TOPGU-1 LOC #:. ADDITIONAL REMARKS SCHEDULE Page 1 of 1 i & Olson Ltd Top Gun. Pressure Washing, LLC 500 W. 67th St. NUMBER Loveland CO 80538 DATE: THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: CERTIFICATE OF LIABILITY INSURANCE LIABILITY APPLIES PER POLICY TERMS AND WRAP EXCLUSION APPLIES PER POLICY TERMS AND CONDITIONS Coverages: :D/RENTED EQUIPMENT POLICY Number:BB845589 Effective Date: 7-1-20 to 7-1-21 r: Travelers Prop Cas Co of Amer (NAIL # 25674)._ 6100,600 tible: $1,000 VIE POLICY .y Number. CPA3235676 ,y Effective Date: 3 4-20 to 3 4 21 rer: Union Insurance Company (NAIC #25844) t of Clients Property Limit: $100,000 uctible: $1,000 )62 Form Attached Includes: Additional Insured — Competed Operations status when required by written contract. Form Attached Includes: Primary & Non -Contributory status to Additional insured applies when required by a written contract. t92 Form Attached Includes: Additional Insured — Ongoing Operations status when required by written contract. Additional Insured for Various Relationships when required by written contract or written agreement. Waiver of Subrogation applies when required by written contract. )93 Form Attached Includes: Additional Insured status applies when required by written contract. Waiver of Subrogation applies when required by written contract. Primary & Non -Contributory status to Additional insured applies when required by a written contract. :RS COMPENSATION 113 Form Attached Includes: Waiver of Subrogation applies when required by written contract. LA LIABILITY Liability policy is on a follow form basis for the following underlying insurance coverages: General Liability, Automobile Liability and Employers Liability. F&rm Attached Includes: I Insured status including Primary and Non -Contributory status, will follow form when required by written contract. ITION LIABILITY: Number: 604/865555 Effective Date: 7-1-20 to 7-1-21 -: Columbia Casualty Company (NAIC # 31127) aim Limit: $1,000,000 late Limit: $1,000,000 sured Retention: V0,000 138XX Form Attached Includes: Additional Insured status when required by written contractor written agreement. Blanket Primary & Non -Contributory status to Additional insured when required by a written contract or written agreement. i62XX Form Attached Indudes: Waiver of applies when required by written contract. policy forms referenced will be sent via email only. To obtain copies, please send your request with the email address to Certificates@olsonandolson.com Work. I Insured(s): The City, its officers, agents and employees. © 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD