Loading...
HomeMy WebLinkAbout462834 FOOTHILLS LANDSCAPE MAINTENANCE LLC - INSURANCE CERTIFICATE (3)FHLAN-1 OP ID: JD CERTIFICATE OF LIABILITY INSURANCE DA04128/201TE V) 04128/2015 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 3rown & Brown Inc 1,532 Boardwalk Dr, Suite 200 -on Collins, CO 80525 B. Allen 970-482-7747 970-484-4165 INSURER A: Pinnacol Assurance Company 41190 INSURED Foothills Landscape INSURERS:AMCO Insurance Company 19100 Maintenance, LLC P. O. Box 189 INSURER C: Nationwide Mutual Fire Ins Co. 23779 Windsor, CO 80550-0189 INSURER D: INSURER E : 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 REDUCED BY PAID CLAIMS. INSR LTR I TYPE OF INSURANCEADDL SUER POLICY NUMBER POLICY EFF MMtDDIYYYY POLICY EXP MMIDDIYYYY LIMITS B X COMMERCIAL GENERALLIABILITY CLAMS -MADE T OCCUR X CP3007035175 05/01/20'15 0501/2016 EACH OCCURRENCE $ 1,000,00 PREMISES Ea occurrence $ 100,00 MED EXP (Any one person) $ 10,00 PERSONAL &ADV INJURY $ 1,000,00 GENrL AGGREGATE LIMIT APPLIES PER POLICY PRO- JEcT LOC OTHER: GENERAL AGGREGATE $ 2,000,0011 PRODUCTS -COMPlOP AGG $ 2,000,0011 $ C AUTOMOBILE LIABILITY ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS � NON -OWNED HIRED AUTOS X ACP3007035176 0510112015 05/01/2016 COMBINED SINGLE LIMIT Ea accident $ 1,000,00 X BODILY INJURY (Per person) $ BODILY INJURY (Per accident) S PROPERTY DAMAGE Per accident $ $ X UMBRELLA LIAR B ~EXCESSUAB X OCCUR -M CLAIMSADE CP3007035176 O5J01/2015 05101/2016 EACH OCCURRENCE $ 2,000,00 AGGREGATE $ 2,000,00 DELI I X I RETENTION$ 0 $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANVPROPRIETOR/PARTNER/EXECUTIVE YIN OFFICERIMEMBER EXCLUDED? N❑ (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS beks N I A 154852 0410112015 04101/2016 X I PER H- STATUTE ER $ 1,000,00 - - $ 1,000,00 1 $ 1,000,00 E.L. EACH ACCIDENT E.L. DISEASE - EA EMPLOYEE E.L. DISEASE - POLICY LIMIT B Equipment Floater ACP3007035175 05M7/2015 05M7/2016 Lsd/Rtd 50,000 Ded 1,00 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space is required) The certificate holder is included as an additional insured per forms and conditions shown on page 2. CITYFC2 City of Fort Collins 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. AUTHORIZED REPRESENTATIVE ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD FHLAN-1 PAGE 2 NOTEPAD INSUREDS NAME Foothills Landscape OP ID: JD Date 04/28/2015 The following apply when required by contract: GENERAL LIABILITY: Additional Insured On -going & Completed Operations CG7246 09/08 Primary/Non-Contributory Wording CG7246 09/08 Blanket Waiver of Subrogation CG7158 08/04 Per Project Aggregate CG2503 05/09 TONOBILE LIABILITY: ditional Insured On -going Operations AC0102 03/10 anket Waiver of Subrogation AC 0101A 03/10 LIABILITY: form ' COMPENSATION: Waiver of Subrogation 359-B