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HomeMy WebLinkAbout510238 GREENING UP LANDSCAPE MAINTENANCE INC - INSURANCE CERTIFICATEGREEN-U OP ID: DA ACORO� r ATE (MM/DDlYYYY) CERTIFICATE OF LIABILITY INSURANCE TE(MM/ DIYY 015 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 CONTACT NAME: Diana Vigil Brown &Brown Inc PHONE 970-482-7747 aC No): 970-484-4165 4532 Boardwalk Dr, Suite 200 A/C No Ell: Fort Collins, CO 80525 ADESS: dvlgil@bbcolorado.com Karen E. Siwek, CPA INSURERS AFFORDING COVERAGE NAIC # INSURER A: Westfield Insurance Company 24112 INSURED Greening Up Landscape INSURER B: Pinnacol Assurance Company 41190 Maintenance, Inc. 5200 Beverly Drive INSURERC: Berthoud, CO 80513-8602 INSURERD: INSURER E INSURER F C/1\/FQArGC CERTIFICATE Ni IMRFR• RFVISIAN NIIMRFR- 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. IN —SR- TYPE OF INSURANCE DL SUBR POLICY NUMBER MMLDD/YYYY MML LTR DD YYY LIMITS i A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1+000+00 CLAIMS -MADE Fit] OCCUR X X CWP6058374 06/01/2015 06/01/2016 DAMAGE TO RENTED PREMISES Ea occurrence 300 00 $ + MED EXP (Any one person) $ 5,00 PERSONAL & ADV INJURY $ 1,000,00 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,00 � LOC POLICY PE� PRODUCTS - COMP/OP AGG $ 2,000,00 $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ 1 000 00 _ BODILY INJURY (Per person) A X ANY AUTO X X CWP6058374 06/01/2015 06/01/2016 $ BODILY INJURY (Per accident) $ ALL OWNED SCHEDULED AUTOS AUTOS NON -OWNED HIRED AUTOS AUTOS PROPERTY DAMAGE Per accident $ X UMBRELLA LIAB X OCCUR - EACH OCCURRENCE $ 3,000,00 AGGREGATE $ 3,000,00 A EXCESS LU\B CLAIMS -MADE CWP6058374 06/01/2015 OW0112016 DED I X RETENTION $ 0 $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y / N X 4094235 06/01/2015 06/01/2016 X PER OTH- STATUTE ER E.L. EACH ACCIDENT $ 600,00 OFFICER/MEMBER EXCLUDED? ❑ (Mandatory in NH) N / A E.L. DISEASE - EA EMPLOYEE $ 600,00 I E.L. DISEASE - POLICY LIMIT $ 500,00 If yes describe under DESCRIPTION OF OPERATIONS below A Leased/Rented Eq CWP6058374 06/01/2015 06/01/2016 Lsd/Rntd 25,00 Ded 50 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 Additional Insured as respects to General Liabliity and Automobile Liability per policy forms and conditions - See page 2 Fax#970-221-6707 1`CQTICI1'ATF Urli rII=Q CAAICFI I ATIr)N CITYF11 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 P O Box 5080 Fort Collins, CO 80522 AUTHORIZED REPRESENTATIVE/ _ . Q © 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD GREEN-U NOTEPAD INSURED'SNAME Greening Up Landscape OP ID: DA If Required By Written Contract: Commercial General Liability: Blanket additional insured applies for ongoing and completed operations CG2033 6 CG2037 Primary, non-contributory basis CG 2001 Blanket waiver of subrogation CG7133 Per project aggregate CG2503. Commercial Auto Liability: Blanket Additional Insured and waiver of subrogation CA7068. Workers Compensation: Blanket waiver of subrogation applies per form 359-B. ella follows form. PAGE 2 Date 06/02/2015