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Home My WebLink About124948 TOP GUN PRESSURE WASHING LLC - INSURANCE CERTIFICATE (4)ACORO CERTIFICATE F LIABILITY INSURANCE ILIA I It(mMruUITTrr) l�� 6/29/2020 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFOR ATION ONLY AND CONFERS' NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGAT LY AMEND, EXTEND OR ALTER THE COVERAGEAFFORDED 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 maV require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement($). I Olson & Olson. Ltd 5665 S. Yosemite St. Q00 Greenwood Village CO 80111 INSURED Top Gun Pressure Washing, LLC 500 W. 67th St. Loveland GO 80538 TOPGU-1 INSURER E : 303-867-2055 .com CflVFRAf:FS CFRTIFICATF FJIIMRF0-'%A77q'311r RFVISIf1N MIIMRFR- THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSUIj EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS ANC E AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADDL SUER POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DDM/YY LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE O OCCUR CPA323567 3/4/2020 3/412021 EACH OCCURRENCE $1,D00,000 DAMAGE TO RENTED PREMISES Ea occurrence $ 500,000 MEDEXP (Any one person) $ 10,000 PERSONAL S ADV INJURY $ 1,000,000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY ^ 1 PRO IIELOC PRODUCTS -COMPIOP AGG $2,000,000 Is A " "------ AUTOMOBILE LIABILITY ANY AUTO ALL OWNED SCHEDULED AUTOHIRED SAUTOS X AUTOS AUTOS NON -OWNED IX -' -- CPA3235676 "- ""- 314/2020 3142021 COMBINED SINGLE LIMIT Ea accident T a0 000 BODILY.INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ A X UMBRELLA LJAS X I OCCUR EXCESS LIAR CLAIMS CPA3235671 - 3/4/2020 314/2021 EACH OCCURRENCE $1 0000,()DO AGGREGATE $10,000,000 - DED X RETENTION $ NIA Is C WORKERS COMPENSATION AND EMPLOYERS' UA ury Y / N ANY PROPRIETOWPARTNERIEXECUTIVE OFFICERIMEMBER EXCLUDED? N (Mandatory in NH) If es, describe under DESCRIPTION OF OPERATIONS below NIA 4031609 7/12020 7f1/2021 X WC STATU- OTH- - E.L. EACH ACCIDENT $ 1.000,000 E.L. DISEASE - EA EMPLOYE $1,000,000 E.L. DISEASE - POLICY LIMIT I $1,000,000 B Excess Liability NHAO89286 3/4/2020 3/412021 tech Occurrence - 5,000,000 Aggregate 5,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (Attach ACORD 101, See Attached... Additional Remarks Schedule, If more apace is required) City of Fort Collins Purchasing Division PO Box 580 Fort Collins CO 80522-0580 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 ACORD 25 (2010/05) 01988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered.maft of ACORD AGENCY CUSTOMER ID: TOPGU-1 LOC #: ACO ® ADDITIONAL REMARKS SCHEDULE Page 1 of 1 AGENCY Olson & Olson Ltd NAMED INSURED Top Gun Pressure Washing, LLC 500 W. 67t1i St. Loveland CO 80538 POLICY NUMBER CARRIER NAIC CODE EFFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: CERTIFICATE OF LIABILITY INSURANCE CONTRACTUAL LIABILITY APPLIES PER POLICY TERMS AND CONDITIONS A WRAP EXCLUSION APPLIES PER POLICY TERMS AND CONDITIONS Other Coverages: LEASED/RENTED EQUIPMENT POLICY Policy Number: BB845589 Policy Effective Date: 7-1-20 to 7-1-21 Insurer. Travelers Prop Cas Co of Amer (NAIC # 25674) Limit: $100,000 Deductible: $1,000 CRIME POLICY Policy Number: CPA3235676 Policy Effective Date: 3-4-20 to 3-4-21 Insurer: Union Insurance Company (NAIC #25844) Theft of Client's Property Limit: $160,000 Deductible: $1,000 GENERAL LIABILITY: CLCG2062 Form Attached Includes: Blanket Additional Insured — Competed Operations status when required by written contract. CA2001 Form Attached Includes: Blanket Primary & Non -Contributory status to Additional insured applies when required by a written contract. CLCGO492 Form Attached Includes: Blanket Additional Insured — Ongoing Operations status when required by written contract. Blanket Additional Insured for Various Relationships when required by written contract or written agreement. Blanket Waiver of Subrogation applies when required by written contract. AUTO LIABILITY: CLCA2093 Forth Attached Includes: Blanket Additional Insured status applies when required by written contract. Blanket Waiver of Subrogation applies when required by written contract. Blanket Primary & Non -Contributory status to Additional insured applies when required by a written contract. WORKERS COMPENSATION WC000313 Form Attached Includes: Blanket Waiver of Subrogation applies when required by written contract. UMBRELLA LIABILITY Umbrella Liability policy is on a follow form basis for the following underlying insurance coverages: General Liability, Automobile Liability and Employers Liability. CW1054 Form Attached Includes: Additional Insured status including Primary and Non -Contributory status, will follow form when required by written contract. POLLUTION LIABILITY: Policy Number: 6049865555 Policy Effective Date: 7-1-20 to 7-1-21 Insurer: Columbia Casualty Company (NAIC # 31127) Per Claim Limit: $1,000,000 Aggregate Limit: $1,000,000 Self -Insured Retention: $101000, CNA90038XX Form Attached Includes: Blanket Additional Insured status when required by written contract or written agreement. Blanket Primary & Non -Contributory status to Additional insured applies when required by a written contract or written agreement. CNA83662XX Form Attached Includes: Blanket Waiver of Subrogation applies when required by written contract. IMPORTANT: The policy forms referenced will be sent via email only. To obtain copies, please send your request with the email address to Certificates@olsonandolson.com Contract Work - Old Town downtown sidewalk & Pavement area. Additional Insured(s): City of Fort Collins ACORD 101 (2008101) @ 2068 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD