HomeMy WebLinkAbout361699 ZAK GEORGE LANDSCAPING LLC - INSURANCE CERTIFICATE (2)ACORV CERTIFICATE OF LIABILITY INSURANCE
DATE (MWODIYYYY)
03/24/2020
THIS CERTIFICATE IS ISSUED AS A MATTER OFINFORMATION 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, the policy((es) 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).
PRODUCER
Flood and Peterson
PO Box 578
Greeley CO 80632
Nam., Kylie Carey, CISR, CIC
PNONE (970) 266 7146
lAIr F No, (970) 506-6845
E-MAIL s: KCar_eyNfloodpeterson.com
ADDRE
.INSURERS AFFORDING COVERAGE ... _.. _
NAIC e
INSURER A: CIOCInnab Indemnity CD
23280
INSURED
Zak George Landscaping, LLC
rgINSURER
335 S. Summit View Drive
Fort Collins CO 60524
INSURERS: Plnnecol Assurance
41190
C
INSURER D:
INSURER E :
INSURER F:
1 nvcoer_ee" rcRrLCIrAYt M111MAPP- FullCerIx4/1/21 -:ZGL. REVISION NUMBER:
----
THIS IS TOCERTIFYTHAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THEINSURED 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 MAYBE 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.
INSR
LTR
..
TYPE OF INSURANCE
fI
POLICY NUMBER
POLICY EFF
P O
11Mffi
COM$LERCLALGENERALumil ITY
EACH OCCURRENCE
$ 1,000,000
CLAIMS -MADE � OCCUR
DA
PREMI " - "" --TL7renW
$ 500,000
MED EXP onePerson)
$ 10,000
PD Ded.: $1,000
A
--
Y
EPP0472465
04/01/2620
04/01/2021
PERSONAL &ADV INJURY
$ 1,000,000
GEN-LAGGREGATE LIMIT APPLIES PER:
GENERAL AGGREGATE
2.000;000
PRODUCTS•.COMP/OP AGG
$ 2,000,000
POLICY PRO-
❑X ECT LOC
OTHER: .
IStop-Gap-WY
$ 1,000,000
AUTOMOBILE LIABILITY
-
COMBINED SINGLE LIMIT
Ea accident
$ 1,000,000
BODILY INJURY (Per Person)
$
v ANYAUTO
A
OWNED SCHEDULED
AUTOS ONLY AUTOS
HIRED NON -OWNED
AUTOS ONLY AUTOS ONLY
Y
EPP0472465
04/01/2020
04/01/2021
BODILY INJURY (Per accident)
S
PROPERTY DAMAGE
Per ecdd�t
$
Medical payments
$ 5,000
UrrBIRELLALIAB
OCCUR
EACH OCCURRENCE.
$ 5,000,000.
AGGREGATE
$ 5,000,000
A
I EXCESSUAe
CLAIMS -MADE
EPP0472465
04/01/2020
04/01/2021
DED I RETENTION $
$
- ---
-- --- -
-
�-PER
B
WORKERS COMPENSATION
AND EMPLOYERS' UABILRY
ANYPROPRIETORMA.RTNER/EXECUTIVE YIN
OFFICERIMEMBER EXCLUDED?
(Mandatory in 1411)
N/A
- -- -
4163537
04/01/2020
04/01/2021
STATUTE FOR -
E.L EACH ACCIDENT
$ 1,0001000
E.L DISEASE- EA EMPLOYEE
S 1,000,000
E.L. DISEASE- POLICY LIMIT
$ 1,000,000
If yea, deecrtbe under
DESCRIPTION OF OPERATIONS below
A
Leased/Rented. Equipment
EPP0472465
0401/2020
04/01/2021
00,000Iimk
$2,500 Ded.
DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Addhimal Remarks Sehe"o, may be alteehed If more apace is required)
Certificate holder is included as Additional Insured as required by written contract with respects to liability arising out of work performed by the named
insured. 80 day notice of cancellation applies in favor of: City of Fort Collins
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.
215 N Mason - -"- - -
Fort Collins CO 80524
ACORD25 (2016W) The ACORD name and logo are registered marks of ACORD