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Home My WebLink About106253 SERVICEMASTER OF FORT COLLINS - INSURANCE CERTIFICATE (2)11 A� " CERTIFICATE OF LIABILITY INSURANCE DATE /28/20/YYV1) 05/28/2020 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, fire policy(les) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain pollcles may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endoreement(s). PRODUCER Brown & Brown of Colorado, Inc. 4532 Boardwalk Dr., Suite 200 Fort Collins CO 80625 CONTACT NAME: Jody Hanis PHONE " - (970)482-7747 ___ _ -.. AIC NoFAX : (870)484�165 ADDRIE55: certificates@bbcolorado.com INSURER(S) AFFORDING COVERAGE NAIC0 INSURER A: Capitol Specialty Insurance Corp 10328 INSURED I HIS Inc. dba ServiceMaster of Fort Collins dba ServiceMaster of Loveland dba ServidsMaster Solutions 3054 Lake Canal Ct #120 Fort Collins CO 80524 INSURER B: Westfield Insurance Company 24112 INSURER C : Pinnacal Assurance 41190 INSURER u:._North AmericanSpeaalty InsUranc_e_Conipany_ _ 29874 INSURER Et Philadelphia Indemnity Ins Co 18058 INSURER F : CnVFRAGFS CERTIFICATE NUMBER- 20-21 HS Master 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 .D000MENT WfTH RESPECT TO WHICH THIS CERTIFICATE MAYBE ISSUED OR MAY PERTAIN, THE INSURANCEIAFFORDED 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. TR TYPE OF INSURANCEWLbVCKI POLICY NUMBER POLICY V.FF MMIDOIYYYY POLICY EXP MMM LIMITS x COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE S 1,000,000 CLAIMS -MADE 7x OCCUR PREMISES Ee occunence $ 50,000 x WED EXP one S_5,000 _ Pollution/Mold x CPL/Professional PERSONAL&ADVINJURY_ $.1,000,000 - A E1/20191351-02 06/01/2020 06/01/2021 GEMLAGGREGATE UIVITAPPLIES PER: GENERALAGGREGATE S 2,000,000 X POLICY O JET LOC PRODUCTS - COMPIOPAGG $ 2,000,000 $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Me accident s 1,000,000 X BODILY INJURY (Per person) $ ANY AUTO B OWNED SCHEDULED AUTOSONLY AUTOS HIRED NON -OWNED AUTOS ONLY AUTOS ONLY CWP6099227 "- -' OB/01/2020 - OB/01%2021 - - _BODILY INJU_RV(Peraccidem) - -- S PROPERTY DAMAGE Per accident $ S I - UMBRELLALUAB OCCUR EACH OCCURRENCE $ 2,000,000 AGGREGATE $ 2,000,000 A EXCESS LIAB CLAIMS -MADE EX20191352-02 06/01/2020 08/01/2021 DED I >< RETENTION $ 10,000 S C - WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNERIEXECUTIVE YIN OFFICER/MEMBEREXCLUE ❑N (Mandatory In NH) _- _ NIA I - .. 4166362 - 06/01/2020 06/01/2021 x Si1'ATUTE I I ERH E.L EACH ACCIDENT $ 1,000,000 E.LDISEASE- EAEMPLOYEE $-1,000,000 If yes. de3e ibe under DESCRIPTION OF OPERATIONS below I E.L DISEASE - POLICY UNIT $ 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, AddMo6al Remarks Schedule, may be attached if mom space is requlmd) 970-224-6134 rcC mtC ILTc unr nco i r-AMrF1 I ATTnM - SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Fort Collins ACCORDANCE NTH THE POLICY PROVISIONS. P.O. BOX 580 AUTHORIZED REPRESENTATIVE Fort Collins CO 60522 1 ® 1983-2015 ACORD CORPORATION. All rights reaerVefl. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: LOC #: '4� ADDITIONAL REMARKS SCHEDULE Page _ of AGENCY Brown & Brown of Colorado, Inc. NAMED INSURED HS Inc. dba ServiceMaster of Fort Collins dba _ POLICY NUMBER CARRIER NAIC CODE EFFECTIVE DATE: THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: Certificate of Liability Insurance: Notes Specialty Insurance Company - Insurer "D" Term: 06/01 /2020 to 06/012021 -once Limit: $1,Ob0,0017 yment Practices Liability Insurance: underwitten by Philadelphia Insurance - Insurer "E" #PHSD1543510 71arm: 06/012020 to 06/012021 ,ence Limit: $t,606,000 Crime Insurance: P014 underwritten by Westfield Insurance Company - Insurer "B" Policy #CWP6099227 Polity Term: 66/01 /2020 to 06/012021 Employee Theft Limit: $25,000 L Limit: Company - Insurer "B" required by written contract, the following form(s) may apply: Liability: Additional Insured - Ongoing Operations Additional Insured - Completed Operations Waiver of Subrogation & Non -Contributory Liability: )0 Separate & Dedicated Limit outside of the General Liability Limit listed on page 1 Blanket Additional Insured - Form CA7078 Scheduled Additional Insured - Form IL7032 Blanket Waiver of Subrogation - Form CA0444 Workers Compensation: Blanket Waiver of Subrogation - Farm 359-8 I Umbrella policy is follow form The ACORD name and logo are registered marks of ACORD