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HomeMy WebLinkAbout107133 BATH INC - INSURANCE CERTIFICATE (13)ACOROr CERTIFICATE OF LIABILITY INSURANCE `...-/ D/DDI 10/19/2015 /19 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 Flood and Peterson Box 578 Greeley CO 80632 CONTACT NAME: Jennifer Winter, CISR PHONE (97O)SO6-3206 FpC No:(970)506-6846 AICPO ADDRESS:JWinter@floodpeterson.com INSURERS AFFORDING COVERAGE NAIC # INSURER ADe ositors Insurance Company 42587 INSURED Bath, Inc. 2000 E. Prospect Road Fort Collins CO 80525 INSURERBAllled Property and Casualty 42579 INSURER C AMCO Insurance Company 19100 INSURERD:Pinnacol Assurance 41190 INSURER E : 1 INSURERF: COVERAGES CERTIFICATE NUMBER:CL15101906513 REVISION Nl1MRFR 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 INSR WBDR POLICY NUMBER MMLDDYYYYY MM DD YYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE a OCCUR PCPGLD03016878298 11/1/2015 11/1/2016 DAMAGE To RENTED PREMISES Ea occurrence $ 300,000 MED EXP (Any one person) $ 10,000 PERSONAL & ADV INJURY $ 1,000,000 X PD Ded: 500 GENERAL AGGREGATE $ 2,000,000 GENT AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2,000,000 POLICY X PRO LOC $ AUTOMOBILE LIABILITY Ee aBINED(SINGLE LIMIT 1,000,600 X BODILY INJURY (Per person) $ B ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS ACPBAPC3016878298 11/1/2015 11/1/2016 BODILY INJURY (Per accident ) $ X HIRED AUTOS X NON -OWNED AUTOS PROPERTY DAMAGE Per accident $ X $ Drive Other Car X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 5,000,000 AGGREGATE $ 5,000,000 C EXCESS LIAB CLAIMS -MADE DED I X I RETENTION$ 0 $ ACPCAA3016878298 11/1/2015 11/1/2016 D WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y I NTOR ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under N I A 4015110 11/1/2015 11/1/2016 X WC STATU- I OTH- E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE - POLICY LIMIT $ 1 000,000 DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) RE: Neighborhood Street Tree Replacement #7205 City of Fort Collins, its officers, agents, and employees are listed as Additional Insureds as respects General Liability, including completed operations, and Auto Liability. Insurance is primary and non-contributory. �rx i I r= nUL_UF_rc L:ANL tLLA I IVN City of Fort Collins PO Box 580 Fort Collins, CO 80521 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 J Winter, CISR/JWINTE /A%,UMLJ co (ZV I VIVO) INS025 rvmnns m ©1988-2010 ACORD CORPORATION. All rights reserved. TFhn Arr1Rr1 nmma onr1 Innn — rnnictnrorl marlrc of Ar r)pn ACORa CERTIFICATE OF LIABILITY INSURANCEF10/19/20Y15 �� DATE (MMIDD/YYY) 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 Flood and Peterson PO BOX 578 Greeley CO 80632 CONTACT NAME: Jennifer Winter, CISR PHONE IA (970)506-3206 FA/No: (970)506-6846 AIL ADDRESS:JWinter@floodpeterson.com INSURERS AFFORDING COVERAGE NAIC # INSURER ADepos-itors Insurance Company 42587 INSURED Bath, Inc. 2000 E. Prospect Road Fort Collins CO 80525 INSURER B-All led Property and Casualty 42579 INSURER C AMCO Insurance Company 19100 INSURERD:Pinnacol Assurance 41190 INSURER E INSURERF: COVERAGES CERTIFICATE NUMBER-CL15101906513 REVISI0N 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 TYPE OF INSURANCE I L WV R POLICY NUMBER MM`DD/YYYY MMLDD/YYXYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE Fx_1 OCCUR IkCPGLD03016878298 11/1/2015 11/1/2016 DAMAGE TO RENTEDPREMISES Ea occurrence $ 300,000 MED EXP (Any one person) $ 10,000 X PD Ded: 500 PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2,000,000 POLICY X PRO LOC $ AUTOMOBILE LIABILITY EOMaBINdEDtSINGLE LIMIT 1,000,000 X BODILY INJURY (Per person) $ B ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS ACPBAPC3016878298 11/1/2015 11/1/2016 gODILYINJURY (Per accident) $ HIRED AUTOS X NON -OWNED AUTOS X PROPERTY DAMAGE Per accident $ X $ Drive Other Car X UMBRELLA LIAR X OCCUR EACH OCCURRENCE $ 5,000,000 14DED AGGREGATE $ 5,000,000 C EXCESS LIAB CLAIMS -MADE I X I RETENTION$ C $ CPCAA3016878298 11/1/2015 11/1/2016 D WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under N/A 4015110 11/1/2015 11/1/2016 WC STATU- OTH- X T VI ER E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE - POLICY LIMIT $ i 000 000 DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) RE: South Transit Center, 4915 Fossil Blvd., Fort Collins, CO 80525 City of Fort Collins, its officers, agents, and employees are listed as Additional Insureds as respects General Liability, including completed operations, and Auto Liability. Insurance is primary and non-contributory. (970)221-6707 City of Fort Collins PO Box 580 Fort Collins, CO 80522 1.111Yl,CLLA I IVIV 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 J Winter, CISR/JWINTE A%,Urtu ca twIUIUD) INRn25 r?mnnai m ©1988-2010 ACORD CORPORATION. All rights reserved. Tha Ar11Rr1 name and Innn am raniato—ri marlte of ACl1Rr1 ACORO� CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) F10/19/2015 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 CONTACT NAME: Jennifer Winter, CISR Flood and Peterson PO Box 578 PHONE (97O)SO6-3206 FAX (970)506-6846 A/C No): AEDORIe :JWinter@floodpeterson.com INSURERS AFFORDING COVERAGE NAIC # Greeley CO 80632 INSURER ADe ositors Insurance Company 42587 INSURED INSURERBAllled Property and Casualty 42579 Bath, Inc. INSURERCAMCO Insurance Company 19100 2000 E. Prospect Road INSURERD:Pinnacol Assurance 41190 INSURER E : Fort Collins CO 80525 INSURER F: COVERAGES CERTIFICATE NUMBER:CL15101906513 RFVISInNI NI IMRFR- 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. ILTR TYPE OF INSURANCE IN L W BR POLICY NUMBER MM/DD/YYYY MMIDD/YYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED PREMISES Ea occurrence $ 300,000 A CLAIMS -MADE a OCCUR ACPGLD03016878298 11/1/2015 11/1/2016 MED EXP (Any one person) $ 10,000 X PD Ded:500 PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2,000,000 POLICY X PRO LOC $ AUTOMOBILE LIABILITY EOMaBcINdEeDtSINGLE LIMIT 1,000,000 X BODILY INJURY (Per person) $ B ANY AUTO BODILY INJURY Per accident ( ) $ ALL OWNED SCHEDULED AUTOS AUTOS ACPBAPC3016878298 11/1/2015 11/1/2016 HIRED AUTOS X NON -OWNED AUTOS X PROPERTY DAMAGE Per accident $ X $ Drive Other Car X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 5,000,000 14DED AGGREGATE $ 5,000,000 C EXCESS LIAB CLAIMS -MADE I X RETENTION$ 0 $ ACPCAA3016878298 11/1/2015 11/1/2016 D WORKERS COMPENSATION X WC STATU- OTH- AND EMPLOYERS' LIABILITY Y / NFIR E.L. EACH ACCIDENT $ 1,000,000 ANY PROPRIETOR/PARTNER/EXECUTIVE 1K NIA OFFICER/MEMBER EXCLUDED? (Mandatory in NH) 4015110 11/1/2015 11/1/2016 If yes, describe under E.L. DISEASE - EA EMPLOYE $ 1,000,000 E.L. DISEASE - POLICY LIMIT $ 1 G00 000 DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) RE: Discovery Museum Landscaping City of Fort Collins, its officers, agents, and employees are listed as Additional Insureds as respects General Liability, including completed operations, and Auto Liability. Insurance is primary and non-contributory. " nywGr[ I.ANL r_LL.A I IUN (970)221-6707 City of Fort Collins Purchasing Division 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 J Winter, CISR/JWINTE M%,Urcu co (cu I ulua) IN8025 mmnnsl n1 U 1988-201 U AGORD CORPORATION. All rights reserved. The Ar npn namc nnrl Innn mrc ranietnrnrf mmrlre of Ar npn