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HomeMy WebLinkAbout111134 MILL BROTHERS LANDSCAPE & NURSERY INC - INSURANCE CERTIFICATE (3)r� OP ID: RC ACORN TE CERTIFICATE OF LIABILITY INSURANCE Do623/20YYYY) /23I15 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: PFS Insurance Group - JT PHONE FAX 4848 Thompson Pkwy, Ste 200 A/C No, Ext : A/c No): Johnstown, CO 80534 E-MAIL ADDRESS: Dave Janssen PRODUCER MILLB-2 ri mTniurp in m• _ INSURER(S) AFFORDING COVERAGE NAIC # INSURED MITI Brothers Landscape & INSURER A: EMC Insurance Companies 21415 Nursery, Inc., MB Design Group INSURER B: Pinnacol Assurance 41190 & MB Golf 6121 E. Harmony Road INSURERC: Fort Collins, CO 80528 INSURERD: INSURER E : INSURER F : rnvGDAr--Gc rFRTIGIrATF NI IMRFR• RFVI-RION 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. INSR TYPE OF INSURANCE D L SUBR POLICY NUMBER MMLDDNYYY MMLICY EXP DD//YYYY LIMITS LTR A GENERAL LIABILITY X I COMMERCIAL GENERAL LIABILITY CLAIMS-MADE ^ i OCCUR X Blanket Add'I Ins 4X95754 07/01/2016 07/01/2016 EACH OCCURRENCE $ 1,000,00 PREM EISES Ea occurrence S ( RENTED PREM $ 300� 00 MED EXP (Any one person) $ 6,00 PERSONAL & ADV INJURY $ 1,000,00 X Blanket Waiver GENERAL AGGREGATE $ 2,000,00 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY X PRO LOC PRODUCTS - COMP/OP AGG $ 2,000,00 $ A A A A AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS 4X95754 07/01/2015 07/01/2016 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,00 X BODILY INJURY (Per person) $ X BODILY INJURY (Per accident) $ PROPERTY DAMAGE (PER ACCIDENT) $ X X $ A UMBRELLA LIAR EXCESS LIAR X OCCUR CLAIMS -MADE 4X95754 07/01 /2015 07/01/2016 EACH OCCURRENCE $ 2,000,00 AGGREGATE $ 2,000,00 -- - - DEDUCTIBLE RETENTION $ $ $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y� OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N / A 3037054 07/01/2015 BLANKET WAIVER OF SUBRO 07/01/2016 X I WC STATU- OTH- T RY LIMIT E.L. EACH ACCIDENT $ 1,000,00 E.L. DISEASE - EA EMPLOYEE $ 1,000,00 E.L. DISEASE - POLICY LIMIT $ 1,000,00 A A Leased/Rented Installation 4C95754 07/01/2016 4C95754 07/01/2015 07/01/2016 07/01/2016 Limit 100,00 Limit 150,00 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) RE: 7034 Cottonwood Glen Overflow Parking Lot Landscape & Irrigation. The City, its officers, agents and employees (see note attached) CERTIFICATE HOLDER CITYFT3 City of Fort Collins P.O. Box 580 Ft. Collins„ CO 80524 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 © 1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009/09) The ACORD name and logo are registered marks of ACORD NOTEPAD. HOLDER CODE CITYFT3 MILLB-2 PAGE 2 INSURED'S NAME Mill Brothers Landscape & OP ID: RC Date 06/23/2015 If required by written contract or written agreement the following provisions apply subject to the policy terms, conditions limitations and exclusions: The referenced (excluding Professional Liability) are included as Additional Insured for ongoing operations under General Liability and Designated Insured under Automobile Liability (except Hired and Non -Owned Automobile) A Waiver of Subrogation applies to those named above for General Liability Automobile Liability and Workers' Compensation. i Contractual Lability is included. Umbrella provides excess coverage over the General Liability, Automobile Liability and Employers Liability. This insurance will apply on a primary, non-contributory basis.