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Home My WebLink About165318 CMS MECHANICAL SERVICES INC - INSURANCE CERTIFICATE (7)CMSME-1 OP ID: JD ,4coR0` CERTIFICATE OF LIABILITY INSURANCE DATE 04/24/20152412015 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 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 Brawn &Brawn Inc 4532 Boardwalk Dr, Suite 200 Fort Collins, CO 80525 Tyler B. Allen CONTACT Jody Wagner _ PHONE 970-482-7747 F No): 970-484-4165 AIC N EMI: E-MAIL wa ne bbcolorado.com ADDRESS: J 9 INSURER(S) AFFORDING COVERAGE NAIC• INSURER A: Depositors Insurance Company 42587 _ INSURED CMS Mechanical Services, Inc. C/o Kristen Luca 609 Technology Circle, Suite A Windsor, CO 80550 INSURERS:AMCO Insurance Company 19100 INsuRERc:Pinnacol Assurance Company 41190 INSURER D: Nationwide Mutual Insurance Co 23787 INSURER E INSURER F nwee Ar_ee reoTlolr ATe MIIW7RFD• 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. INSR LTIR TYPE OF INSURANCE NODIL POLICY NUMBER POLICY EFF MM/DDIYYYY POLICY EXP MM/DDIYYYY LIMITS B X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE [ X] OCCUR X ACP3006558176 0412712015 04127/2016 EACH OCCURRENCE $ 1,000,000 PREMISES Ea occurrence $ 100,00 MED EXP (Any one person) $ 10,00 PERSONAL B ADV INJURY $ 1,000,00 GEML AGGREGATE OMIT APPLIES PER: POLICYO JECT LOC OTHER: GENERAL AGGREGATE $ 2,000,00 PRODUCTS-COMP/OP AGG $ 2,000,00 $ A AUTOMOBILE LIABILITY X ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS NON -OWNED HIRED AUTOS AUTOS X ACP3006558176 04/2712015 04/27/2016 COMBINED SINGLE LIMIT Ea accident $ 1,000,00 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ B X UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE ACP3006558176 04/27/2015 04/2712016 EACH OCCURRENCE $ 2,000,00 AGGREGATE $ 2,000,00 DED X I RETENTION$ 0 $ C WORKERS COMPENSATION AND EMPLOYERS LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y�N/A MI OFFICEREMBER EXCLUDED? (Mandatory in NH) M yes, describe under DESCRIPTION OF OPERATIONS below 105092 06101/2015 OW0112016 J( fk OTPI STATUTE ER E.L. EACH ACCIDENT $ 1,000,00 E.L. DISEASE -EA EMPLOYE $ 1,000,00 $ 1,000,000 r E.L. DISEASE -POLICY LIMIT D Installation Fltr Lsd/Rntd Equip CP3006558176 04/27/2015 0412712016'lnst Fltr 50,000 Lsd/Rtd 50,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) City of Fort Collins is included as an additional insured performs and conditions on page 2. r CCTICIr ATC Uni n1=0 rANrPi I ATION CITYFT5 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of Fort Collins Purchasing P. O. Box 580 AUTHORIZED REPRESENTATIVE Fort Collins, CO 80521 �y-� v3a� �q�, V 1938-ZU14 AUQKU GUHI'UKA I IUN. AU rignts reservea. ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD CMSME-1 PAGE 2 NOTEPAD INSUREDS NAME CMS Mechanical Services, Inc. OP ID: JD Dare 04/24/2015 The following apply when required by contract: RAL LIABILITY: tional Insured On -going & Completed Operations CG7246 09/08 .ary/Non-Contributory Wording CG7246 09/08 ket Waiver of Subrogation CG7158 08/04 Project Aggregate CG2503 05/09 MOBILE LIABILITY: tional Insured On -going Operations AC0102 03/10 ket Waiver of Subrogation AC 0101A 03/10 BRELLA LIABILITY: llowing form REERS' COMPENSATION: anket Waiver of Subrogation 359-B