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462834 FOOTHILLS LANDSCAPE MAINTENANCE LLC - INSURANCE CERTIFICATE (4)
FHLAN-1 OP ID: JD ACORO" CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY)03/14/2016 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 CONTNAME: Jody Wagner Brown 8, Brown Inc PHONE 970-482-7747 FAX 4532 Boardwalk Dr, Suite 200 LA/C. No. Ell: (A/C, No): 970-484-4165 Fort Collins, CO 80525 E-MAIL Tyler B. Allen ADDRESS: Iwa ner bbcolorado.com g INSURER(S) AFFORDING COVERAGE NAIC If INSURER A: Pinnacol Assurance Company 41190 INSURED Foothills Landscape INSURER B: AMCO Insurance Company 19100 Maintenance, LLC INSURER C : Nationwide Mutual Fire Ins Co. 23779 P. O. Box 189 Windsor, CO 80550-0189 INSURER D : INSURER E : INSURER F : rnVFRAnFC rFRTIFIrATF NIIMRFR• RFVI.glnN NI)MRFR- 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 L 013A POLICY NUMBER POLICY EFF MM/DDIYYYY POLICY EXP MMIDD/YYYY LIMITS B X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 CLAIMS -MADE 'C J OCCUR X ACPGLA03007035175 05/01/2016 05/01/2017 PREMISES Ea occurrence $ 100,00 MED EXP (Any one person) $ 10,00 PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,00 POLICY ECT LOC PRODUCTS - COMP/OP AGG $ 2,000,000 _ OTHER: $ AUTOMOBILE LIABILITY COEaMBINED ccidentSINGLE LIMIT a $ 1,000,00 BODILY INJURY (Per person) $ C X ANY AUTO X ACPBA3007035176 05/01/2016 05/01/2017 ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident _ $ NON -OWNED HIREDAUTOS AUTOS F $ X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 2,000,00 AGGREGATE $ 2,000,00 B EXCESS LIAB CLAIMS -MADE ACPCAA3007035176 05/01/2016 05/01/2017 DIED I X I RETENTION $ 0 $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y� OFFICERIMEMBER EXCLUDED? (Mandatory in NH) N / A 154852 04/01/2016 04/01/2017 TH- X STATUTE ER E.L. EACH ACCIDENT $ 1,000,00 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 If describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 1,000,00 B Equipment Floater ACPCIM3007035175 05/01/2016 05/01/2017 Lsd/Rtd 75,000 Ded 1,00 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) The certificate holder is included as an additional insured performs 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 �� v3a%'_9� © 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD NOTEPAD FD: J n+suran'sNAME Foothills Landscape OPP ID: D The following apply when required by contract: NERAL LIABILITY: ditional Insured On -going & Completed Operations CG7246 09/08 imary/Non-Contributory Wording CG7246 09/08 anket Waiver of Subrogation CG7323 11/11 r Project Aggregate CG7323 11/11 TOMOBILE LIABILITY: ditional Insured On -going Operations AC0102 03/10 anket Waiver of Subrogation AC 0101A 03/10 A LIABILITY: ng form ORKERS' COMPENSATION: lanket Waiver of Subrogation 359-B PAGE 2 D,te 03/14/2016