HomeMy WebLinkAbout462834 FOOTHILLS LANDSCAPE MAINTENANCE LLC - INSURANCE CERTIFICATE (6)`� �® CERTIFICATE OF LIABILITY INSURANCE
onr3/24/202)
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 polic "(ies) must have ADDITIONAL INSURED provisions or be endorsed.
ifBUBROGATION 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.'UUNIAUT
NAME: Karole Peters
Madison Insurance Group
PR
A/C NNo E <i ; 3033220800 (AIC, No): 3033220874
ADDRESS: kpeters@madisoninsurance.net
6005oi1[h Cherry St Ste 900
_ INSURER(S) AFFORDING COVERAGE
NAIC #
INSURER A . NATIONWIDE', INSURANCE
23787
Denver C_O. 8_024.6
INSURED
INSURERB: TRAVELERS INSURANCE
19046
Foothills Landscape Maintenance, LLC
INSURER c : PRNACOL ASSURANCE
41190
Po Box 189
INSURER D : CENTRAL MUT INS CO
26230
INSURERS :
Windsor CO 80550
INSURER F:.
COVERAGES CERTIFICATE NUMBER: 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 REOUCED$Y PAID CLAIMS.
LTR
TYPE OF INSURANCE
INSD
WVD
POLICY NUMBER
(MMIDDIYYYY)
(MMIDDIYYYY)
LIMITS
COMMERCIAL GENERAL LIABILITY
EACH OCCURRENCE
$ 1,000,000.
CLAIMS -MADE ® OCCUR
PREMISES'(Ea occurmnce)
$ 100,000
MED EXP (Any one person)
$ 5,000
PERSONAL & ADV INJURY
$ 1,000,000
A
Y
ACPGLD03049733876
04/01/2020
04/01/2021
GEN'L AGGREGATE LIMIT APPLIES PER:
GENERAL AGGREGATE
$ 2,000,000
POLICY ®jRa ❑LOC
PRODUCTS-COMP/OP AGG
$ 2,000,000
$
OTHER:
AUTOMOBILE
LIABILITY
(Ea accident)
$ I,000,OOO
X
BODILY INJURY (Per person)
$
ANY AUTO
D
OWNED SCHEDULED
AUTOS ONLY AUTOS
Y
BAP9913797
04/01/2020
04/01/2021
BODILY INJURY (Per accident)
$
HIRED y NON -OWNED
AUTOS ONLY I► AUTOS ONLY
P
(P.er. accident).
$
X
UMBRELLA LIAB
X
OCCUR
EACH OCCURRENCE
$ 2,060,000
B
EXCESSLIAB
CLAIMS -MADE
ZUP-9IM95774-19-NF
04/01/2020
04/01/2021
AGGREGATE
$ 400Q000
DED._I
I RETENTION$ _
$
_
C
WORKERS COMPENSATION
AND EMPLOYERS IJAB UTY YIN
Y PROPRIETOR/PARTNER/EXECUTIVE
OFFICERIMEMBER EXCLUDED? �N
NIA
4154852
04/01/2020
- -
04/01/2021
yy - - -
J6. STATUTE
UT -
ER.
- - - - -
E.L. EACH ACCIDENT
$ 1,600,000
-
E.L. DISEASE- FA EMPLOYEE
$ 1,600,000
Mandatory In NH)
yyes, describe under _ _
-ESCRIPTION OF OPERATIONSbelow_
_
E.L. DISEASE - POLICY LIMIT
$ 1,000,000
Scheduled Epipment
$299,600
A
Contractors Equipment
ACP CIM 3048733876
04/01/2020
04/01/2021
Leased/Rented Limit
$100,000
Deductible
$1,000
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES ACORD 101, Additional Remarks Schedule, may - be attached If more c - - - --
( pace Is required)
The certificate holder is included as an additional insured in regards to the General and Auto Liability policies per written contract.
City of Fort Collins
its Officers, Agents and Employees
PO Box 580
Fort Collins, CO 80522
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE'DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
KArva Peters
ACORD 26 (2016/03)
The ACORD name and logo are registered marks of ACORD
reserved.