HomeMy WebLinkAboutAMERICAN MECHANICAL SERVICES OF DENVER LLC - INSURANCE CERTIFICATE (3)ACORO� I
CERTIFICATE OF LIABILITY INSURANCE
DATE (MMIDOIYVYY)
�i
613n020
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
REPRESENTATIVEOR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the pollcy(les) 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
M&T Insurance Agency, Inc.
41 University Drive, Ste. 405
Newtown PA 18940
CONTACT
NAME: Jennifer Carroll
PHONE FAx
• 215-504-1219 A/c Ne:215-504.1235
AND ass: Service mtb.com
INSURERS AFFORDING COVERAGE
.NAIC #
INSURER A:. Old. Republic Ins Co.
24147 .
INSURED
American Mechanical Services of Denver, LLC
Branch #9307
AMERII7
INSURER a: Great American Ins Co of NY
22136
INsuRERc: Travelers Casualty Ins Co of America
19046
INSURERD:
6810 S. Tucson Way
Centennial CO 80112,
INSURER E:
.INSURER F:.
COVERAGES CERTIFICATE NUMBER:707015175 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 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 BEENREDUCEDBY PAID CLAIMS.
1�7q
TYPEOFINSURANCE
IADDWV
POLIcYNUMBER
FMOMiLI00 /EYE
�LICr Vy
LIMITS
A
X
cOMMERCIALGENERALLIABILITY
Y
Y
MWZY312166
3/1/2020
3/1/2021
EACH OCCURRENCE
$1.000.000
CLAIMS -MADE OCCUR
PREMISE EaiO aoccou rrenre
—$ 500,000
X
MED EXP (Any one arson)
$ 10.000
Contractual Uab
X
No XCU Excluslon
PERSONAL & ADV INJURY
$1,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
GENERAL AGGREGATE
$2,000,000
POLICY JEST F7 LOC
PRODUCTS - COMPiOP AGG
$2,000,000
$
OTHER:
A
AUTOMOSILELIABILITY
Y
Y
MWTS315582
61/2020
311/2021
C�OMBINEDSINGLE .LIMIT
( a acddenti
$2,000:000
X
BODILY INJURY (Per parson)
$
ANY AUTO
OWNED SCHEDULED
AUTOSONLY AUTOS
BODILY INJURY (Pm accident)
$
X
PaOr acoRd. DAMAGE
$
AUTOS ONLY X AUTOS ONLIREDY
$
COMP 200 Detl COLL 500 Ded
I
C
X
UMBRELLAU
X
OCCUR
Y
Y
ZUP-71N09735.20-NF
611/2020
311/2021
EACH OCCURRENCE
$10,000,000
AGGREGATE
$10,000,000
EXCESSUAB
CLAIMS -MADE
DED I I RETENTION$ n
I
_
$FOLLOWS FORM
A
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY Y I N
ANYPROPRIETOR/PARTNER/EXECIJTIVE
OFFICERlMEMBEREXCLUDED?
NIA
v
MWC312170
3/1/2020
3/1/2021
X AT TE ERH
E.L. EACH ACCIDENT
$1,000,000
(Mandatory In NH)
I E.L. DISEASE - EA EMPLOYEE
$1,000,000
It yes. describe under
DESCRIPTION OF OPERATIONS below
E.L. DISEASE - POLICY LIMIT
$1,000,000
8
Property nstall Floater
Leasedd]]Rented Equipment
MAC159428502
1/1/1020
1/111021
All Risk
Any One Item
$1,000,000
$100,000
DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached U more space Is required)
Continental Insurance Co. NAIC #35289. Policy 06080551764 611120-3/1/21 Excess Over Umbrella Limit: $10,000,000 / Aggregate: $10,000,000.
Commercial General Liability Policy Endorsements: I
CG2010-0413-Additional Insured -Owners, Lessees or Contractors -Scheduled Person or Organization;
CG2037-0413-Additional Insured -Owners, Lessees or Contractors -Completed Operations;
CG2404-0509-Waiver of Transfer of Rights of Recovery Against Others To Us;
Automobile Liability Policy Endorsements: i
CA2048-1013-Designated Insured for Covered Auto Liability Coverage;
CA0444-1013-Waiver, of Transfer of Rights of Recovery Against Others To Us (Waiver of Subrogation);
See Attached...
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
City of Fort Collins
281 N. College Ave., PO Box 580
Fort Collins CO 80526
01988.2015 ACORD CORPORATION. All rights reserved.
ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD
2• of 12 3639
ACO
L-_--
ADDITIONAL
AGENCY CUSTOMER ID: AMERI17
LOC #:
REMARKS SCHEDULE Page . 1, of 1
AGENCY
NAMED INSURED
M&T Insurance Agency, Inc.
American Mechanical Services of Denver, LLC
Branch #9307
6810 S. Tucson Way
POLICY NUMBER
Centennial CO 80112
CARRIER
NAIC CODE
EFFECTIVE DATE:
THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM,
rne�� uuuveo. 25 enou riri r. CERTIFICATE OF LIABILITY INSURANCE
of Our Right to Recover From Others Endorse
101
The ACORD name and logo are registered marks of ACORD
M
3' of 12 3639