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Home My WebLink About429371 HILLEN CORP - INSURANCE CERTIFICATEACORvCERTIFICATE OF LIABILITY INSURANCE DATE //2020 020 Y) 03/2424® THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATNELY 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 hoiden is an ADDITIONAL INSURED, the policy(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 endorsement(s). PRODUCER CONTACT Leigh Pullen NAME: Moody Insurance Agency, Inc. PHCN o,Et: (303) 824-6.800 aC,.No: (303) 370-0118 E-MAIL leigh.pullen@moodyins.com ADDRESS: 8055 East Tufts Avenue INSURER(S) AFFORDING COVERAGE NAIL # Suite 1000 INSURER A': Pinnacol Assurance 41190 Denver CO 80237 INSURED INSURER B : INSURER C : William D Hillen Corporation INSURER D : dba Hillen Corp. INSURER E : 7600 Dahlia Street INSURER F : Commerce City CO 80022 COVERAGES CERTIFICATENUMBER: WC 20/21 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' 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. INSR LTR TYPE OF INSURANCE INSD WVD P.OLICYNUMBER POLICY EFF. MMIDD/YYYY POLICY EXP MM/DD/YYYY LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE. .S A CLAIMS -MADE OCCUR PREMISES Ea occurrence .$ MEO EXP_(Any one person) PERSONAL& ADV. INJURY.. $ N GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE POLICY PRO- JECT ❑ LOC PRODUCTS - COMP/OP.AGG $ $ OTHER: AUTOMOBILE LIABILITY - 'COMBINED SINGLE LIMIT Ea accident) -- BODILY INJURY(Per person) $ ANYAUTO OWNED SCHEDULED AUTOS ONLY AUTOS N BODILY INJURY (Per accident) S PROPERTY DAMAGE - Per accident $ HIRED NON -OWNED AUTOS ONLY AUTOS ONLY $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DED I I RETENTION $ $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? N (Mandatory in NH) N/A 3091443 04/01/2020 04/01/2021 %� STATUTE EORH E.L. EACH ACCIDENT .$ 1,000,000 E.L. DISEASE-. EA EMPLOYEE $ 1,000,000 If ves, describe under DESCRIPTION OF OPERATIONS. below E.L. DISEASE - POLICY LIMIT E 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN The City of Fort Collins Purchasing Department ACCORDANCE WITH THE POLICY PROVISIONS. PO Box'580 AUTHORIZED REPRESENTATIVE Fort Collins CO 80522 "OPY'4 Wk�� ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD