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HomeMy WebLinkAboutMISTER B'S HVAC INC - INSURANCE CERTIFICATE (3)A Ra CERTIFICATE OF LIABILITY INSURANCE DATE07/27/D/YYYY) 7/27/2015 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 endorsements . PRODUCER FEDERATED MUTUAL INSURANCE COMPANY HOME OFFICE: P.O. BOX 328 CONTACT CLIENT CONTACT CENTER PHONE FAX A/c No Ext : 888-333-4949 AIC No): 507-4464664 E-MAIL ADDRESS: CLIENTCONTACTCENTER FEDINS.COM OWATONNA, MN 55060 INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: FEDERATED MUTUAL INSURANCE COMPANY 13935 INSURED 342-538-6 INSURER B: MISTER B'S HVAC INC INSURER C: PO BOX 21756 INSURER D: CHEYENNE, WY 82007 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 49 REVISION NUMBER: 0 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 TYPE OF INSURANCE ADDL INSR SUER WVD POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DD/YYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $1,000,000 COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED PREMISES Ea occurrence $100,000 CLAIMS -MADE X OCCUR MED EXP (Any one person) PERSONAL & ADV INJURY $1,000,000 A X BUSINESS OWNER'S LIABILITY N N 9246984 09/08/2015 09/08/2016 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $2,000,000 X POLICY PROJECT LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $1,000,000 X ANY AUTO BODILY INJURY (Per person) A ALL OWNED SCHEDULED AUTOS AUTOS N N 9246985 09/08/2015 09/08/2016 BODILY INJURY (Per accident) HIRED AUTOS NON -OWNED AUTOS PROPERTY DAMAGE Per accident X UMBRELLA LIAR OCCUR EACH OCCURRENCE $1,000,000 A EXCESS LIAR X CLAIMS -MADE N N 9246986 09/08/2015 09/08/2016 AGGREGATE $1,000,000 DED I RETENTION WC STATU- OTH- ANB EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNERIEXECUTIVE TORY LIMITS ER E.L. EACH ACCIDENT $1,000,000 A OFFICER/MEMBER EXCLUDED? NIA N 9246984 09/08/2015 09/08/2016 E.L. DISEASE - EA EMPLOYEE $1,000,000 (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L DISEASE - POLICY LIMIT $1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) STOP -GAP (EMPLOYER'S LIABILITY) COVERED STATE(S) WY CERTIFICATE HOLDER CANCELLATION 342-538-6 CITY OF FORT COLLINS PO BOX 580 FORT COLLINS, CO 80522-0580 490 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 © 1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD