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HomeMy WebLinkAbout361699 ZAK GEORGE LANDSCAPING LLC - INSURANCE CERTIFICATE (3)i ® - -- - fa�ot® CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDO/YYYY) a3/2a/2o2o 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, 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).,_ PRODUCER., _ NAME - Kyhe Carey, OISR, CIC — PNoyE (970)26.6-7148 (970)'S06 6845 Flood and Peterson. PO Box 578 E-MAIL KCareyGfloodpeterson.wm ADDRESS: INSURERS AFFORDING COVERAGE NAICI. INSURER A: Cincinnati Indemnity Cc 23280 Greeley CO 80632 INSURED INSURER B: Plnnacol Assurance 41190- INSURER C : Zak George Landscaping, LLC INSURER D: 335 S. Summit View Drive INSURER E: INSURER F: Fort Collins CO 80524 COVERAGES CERTIFICATE NUMBER: FuIICerbt4/1/21 - 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 THETERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LM TYPE OF INSURANCE ADOL - POLICY NUMBER MMID nEFF MPOLICY OI umrrs X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE ® OCCUR / PREMISES' o6currance $ 500,000 MED EXP (ArrV oneperson) $ 10,000 PD Ded.: $1,000 PERSONALAADVINJURY $ 1,000,000 A EPP0472465 04/01/2020 04/01/E021 GEN'LAGGREGATE LIMITAPPLIES PER: GENERAL AGGREGATE. $ 2,000,000 PRO - POLICY © ECT LOC - PRODUCTS -COMP/OPAGG $ 2,000,000 Stop -Gap- WY s. 71,000,000 OTHER: AUTOMOBILE LIABILITY . . - COMBINED SINGLE LIMIT c d $ 1,000,000 BODILY INJURY (Per person) $ ANY AUTO A OWNED .. SCHEDULED AUTOS ONLY AUTOS EPP0472465 D4/01/2020 04/01/2021 BODILY .INJURY (Per accident) $ PROPERTY DAMAGE Par idwt $ HIRED M NON -OWNED AUTOS ONLY AUTOS ONLY I Medical payments $ 5,000 UMBRELLA LIAR OCCUR EACH OCCURRENCE $ 5,000,000 AGGREGATE $ 5,000,000 A EXCESSLULB CLAIMS -MADE- EPP0472465 04/01/2020 04/01/2621 DED I RETENTION $ $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N OFFICER/MEMBER EXCLUDED7 (Mandatory to NN) N/A 4103537 04101/2020 04/01/2021 PER OTH- STATUTE ER E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE -.FA EMPLOYEE $ 1,000,000 If yes. describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY .LIMIT $ 1,000,000 A Leased/Re.nted. Equipment EPP0472465 04/01/2020 04/01/2021 $50,000 Limit $2;500 Ded. DESCRIPTION OF OPERATIONS / LOCATONS /VEHICLES (ACORD 101, Additional Ramerka Sehedule, e+eY be attached H more apaw is required) City of Fort, Collins is included as Additional Insured as required by written contract with. respects to liability arising out of work performed by the named insured. 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. 222 Laporte Avenue Fort Collins CO 80521 01988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD