HomeMy WebLinkAbout361699 ZAK GEORGE LANDSCAPING LLC - INSURANCE CERTIFICATEA� o® CERTIFICATE OF LIABILITY INSURANCE
DATE3/24/2020 I�
o3/za/z02o
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), AUTHORIZ_ ED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER..
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) 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 endorsement(s).
PRoouCER - - -
NAME_ Kylie Carey, CISR, CIC
Flood and Peterson
PHONE (970) 266-7148 Ne : (970) 508 6845
PO Box 578
a oaRLss: KCarey®fldddpeterson.ddm
. UISUFIER AFFORDING COVERAGE. - -
.. - _ __
_ _
NAIL 0.
INSURER Ao Cincinnatilndemni_ryC0 _
23260
Greeley CO 80632
INSURED --
INSURER.0:. Pmna661 ASBuraOCe - _ - _
41190
WSURERC:
Zak George Landscaping, LLC
9 9
INSURER 0:
335 S. Summit View Drive
INSURER E :-
INSURER F:
Fort Collins CO 80524
COVERAGES CERTIFICATE NUMBER: FullCerb(4/1/21 - ZGL 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 BEEN REDUCED BY PAID CLAIMS.
ILm
TYPE OF INSURANCE
- S
- -- O
POUCYNUMBER
MMM
MMIG P
LILDTS
CO=IlERCULL GENERAL IUL UTY
EACH OCCURRENCE
$ 1,000,000
CLAIMS -MADE � OCCUR
PREMISES Ea occurrence
$. 500,000
MEO EXP wepawn)
$ 10,000
PD Ded:: $1,000
PERSONAL& ADV INJURY
$ 1,000,000
A
EPP0472465
04/01/2020
04/01/2021
GEN'LAGGREGATE LIMITAPPLIES PER:
GENERALAGGREGATE.
$ 2,000,000
POLICY 19 JECT LOC
PRODUCTS-COMP/OPAGG
$ 2.000,000
Stop -Gap - WY -
$ 1,000,000
OTHER:
AUTOMOBILE
LIABILITY
COMBINtlE&DLfi SINGLE LIMIT
(Fa a0
$ 1,000,000
BODILY INJURY (Per person)
$
ANY AUTO
A
OWNED SCHEDULED
AUTOS ONLY AUTOS
EPP0472465
04/01/2020
04/01/2021
BODILY INJURY (Per acdtlenq
$
PROPERTY DAMAGE
P r 'tlerit
$
HIRED NON -OWNED
AUTOS ONLY AUTOS ONLY
Medical payments
$ 5,000
UMBRELLA LIAB
OCCUR
EACH OCCURRENCE
$ 5,000,000
AGGREGATE
$ 5,000,000
A
EXCESS LIAO
CLAIMS -MADE
EPPO472465
04/01/2WO
04/01/2021
DED I I RETENTION $
$
B
WORKFAS COMPENSATION
AND EMPLWERiP LIABILITY Y/N
ANY PROPRIETORIPARTNER/EXECUTIVE
OFFICERIMEMBER EXCLUDED? I Y I
(Mendakey in NH) _
N/A
4103537
04/01/2020
04/01_/2021
PER OTH-
STATUTE R
E.L. EACH ACCIDENT
$ 1,000,000
E.L. DISEASE .EA EMPLOYEE
1,000,000
It yea, describe under
DESCRIPTION OF OPERATIONS below
E.L DISEASE - POLICY LIMIT
$ 1,000,000
A
Leased/Rented Equipment
-
EPP0472465
04/01/2020
04/01/2021
$50,000 Limit
$2,500 Ded.
DESCRIPTION OF OPERATIONS / LOCATibka / VEHICLFS (ACORD 101, Addidonal Re. m SeMdule, maybe attached N m m epam Is mpuimo
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
City of Fort Collins ACCORDANCE WITH THE POLICY PROVISIONS.
PO Box 580
Fort Collins CO 00522,
CORPORATION. All riahts reserved.
ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD