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Home My WebLink About106253 SERVICES MASTER OF FORT COLLINS - INSURANCE CERTIFICATEACC)REF CERTIFICATI. OF LIABILITY INSURANCE -- _ --- _ DATE(MMID00,20 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 CERTIFICATEOF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING JNSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the Certificate Is an ADDITIONAL INSURED the policy(les) must have ADDITIONAL INSURED provisions or M! endorsed_. ,holder If N I SUBROGATIOS WAIVED, subject to the terms and contlitlons of the policy; certain policles 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:' Jody Hams Brown & Brown of Colorado, Inc. PHONE --- , _ (870f482-774T - -- -- - ---- - — (970) 48"165- 4532Boardwalk Dr., Suite 200 ADDRESS, certificates(dbbColorado:oom - - - INSURE S AFFORDING COVERAGE NAIC 0 INSURERA: Capitol: Specialty Insurance Corp 10328 Fort Collins CO 80525 INSURED INSURER B: WWestfleld InsuranceCompany 24112 HIS Inc. dba Servi"aster of Fort Collins dba INsURERC : Pinnacol Assurance 41190 SeryideMaster of Loveland dba ServiceMasterSolutions INSURER D : Nort.hAnleHddn Specialty Insurance Company 29874 3054 Lake Canal Ct #120 INSURER e` Philadelphia Indemndylns Co - --- 18058- _ INSURERF: Fort Collins CO 80524 COVERAGES 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIESDESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OFBUCH POLICIES. LIMITS SHOWNMAY HAVE BEEN.REDUCED BY PAID CLAIMS. LTR _ _ _ . TYPE OF INSURANCE _ POUCY.NUMBER - ._ _ POLI MMIDD/YYYY . MMID .. _ _ ._... _ —. _. .LIMITS_ _ _ COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE � OCCUR PREMISES Eaoccurence $ 50,000 X NEDEXP (Any oneperson) ,$ 5,000 Pollution/Mold X CPUProfesslonal PERSONAL & ADV INJURY $ 1,00A000 A EV20191351-02 06/01/2020 06/01/2021 GENLAGGREGATE LIMIT APPLIES PER: _ _ X POLICY jEOT LOG .GENERALAGGREGATE $ 2,000,000 - __. - ___ _ .._ -..__ — PRODUCTS-COMP/OFAGG - _2,000,000 E_ — $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Fa =!dent ,$ 1,000,000. X BODILY INJURY (Per Person) .E ANY AUTO B OWNED SCHEDULED AUTOSONLY AUTOS CWVP6098227 06/01/2020 - 06/01/2021 BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accitlen y HIRED NON -OWNED AUTOS ONLY AUTOS ONLY $ — — UMBRELLA UAB OCCUR EACH OCCURRENCE $ 2,000,000 AGGREGATE $ 2,000,000 A I EXCESS UAB CLAIMS -MADE EX20191352-02 06/01/2020 06/01/2021 DED I X RETENTION;E 10,000 $ C WORKERS COMPENSATION AND EMPLOYERS LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBEREXCUUDED9 � (Mandatory. in NH) NIA - 4166362 06/01/2020 - 06/01/2021-. X gT TUTE ERH E.L.ACH ACCIDENT E 1,000,000 E.L. DISEASE -.EA EMPLOYEE .$.11000Y,000 _ If yes, describe under DESCRIPTION. OFOPERATIONS below E.L. DISEASE - POLICY LIMIT 1,000,000 E - DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Seliedule, may be attached if more space Is required) CERTIFICATE HOLDER I CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Ft. Collins ACCORDANCE WITHTHEPOUCY PROVISIONS. 216NMason St AunlowzEDREPReseNTATIVE Fort Collins CO 80522 01988-2015 ACORD CORPORATION. All.rights reserved. ACORD 25 (2016/03) The ACORD mame and logo are registered marks of ACORD AGENCY CUSTOMER ID LOC #: '`=� ADDITIONAL REMARKS SCHEDULE Page _of AGENCY Brown & Brown of Colorado, Inc. NAIC CODE HS Inc. d6a ServiceMaster of. Fort Collins doe THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: Certificate of Liability insurance: Notes Cyber Liability. Insurance: Policy underwitten by North American Specialty Insurance Company - Insurer "D" Policy #C-4LWN-110045-CYBER-2020 Policy Tenn: 66/01)2020 to 06/01/2021 Occurrence Limit: $1,000,000 Employment Practices Liability Insurance: Policy underwitten by Philadelphia Insurance - Insurer "E" Policy APHSD1543510 Policy Tenn: 66/b1/2020 to O6%01/2021 Occurrence Limit: $1,000,000 Insurance: underwritten.by Westfield Insurance Company - Insurer "B" #CWP6099227 Term: 06/01/2020 to 06/01/2021 yee Theft Limit: $25,000 Insurance Company - Insurer "B" Term: 06/01/2020 to O6/01/2021 yeeTheft Limn 325,000 required by written contract, the following form(s) may apply: Additional Insured - Ongoing Operations Additional Insured _ Completed Operations Waiver of Subrogation & Non -Contributory & Dedicated Limit outsideof the General. Liability Limit listed on page 1 Forth CA7078 d - Form I1-7032 on -.Form CA0444 Workers Compensation: Blanket Waiver of Subrogation -. Form 359-B Umbrella policy is follow form The ACORD name and logo are registered marks of ACORD