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HomeMy WebLinkAboutFOUR SEASONS HEATING & AIR INC - INSURANCE CERTIFICATE (2)FOURS-4 OP ID: E1 , k. o CERTIFICATE OF LIABILITY INSURANCE 1►-� 12123/20ATE YYYY) 12/23/2015 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 Brown & Brown of Colorado, Inc 2170 S. Parker Rd Ste 251 CONTANAME: Evie Jo Ontiveros a/c°N o Ext : 720-963-4286 A/c No): 720-962-5142 Denver, COrt 80231 Jason Sartor ADDRE SS: eontiveros@bbdfenver.com INSURERS AFFORDING COVERAGE NAIC # INSURER A:SECURA Supreme Ins Company 10239 _ INSURED Four Seasons Heating Inc INSURER B : Pinnacol Assurance Company 41190 Jay Lauhon 4896 Marshall St INSURER C : Knight Specialty Ins Company 15366 Wheat Ridge, CO 80033 INSURER D : INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: REVISION 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 ADDL UB POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DD/YYYY LIMITS C X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 CLAIMS -MADE Fx7 OCCUR X KSVENA160035002 01/01/2016 01/01/2017 DAMAGE T RENTED PREMISES Ea occurrence $ 50 00 MED EXP (Any one person) $ 5,00 $10,000 DED/OCC PERSONAL & ADV INJURY $ 1,000,00 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,00 POLICY PRO- ❑ JECT LOC PRODUCTS - COMPIOP AGG $ 2,000,00 $ OTHER: AUTOMOBILE LIABILITY MBINED SINGLE LIMIT COEacident ac $ 1,000,00 X BODILY INJURY (Per person) $ A ANY AUTO A3231792 01/01/2016 01/01/2017 ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ HIRED AUTOS NON -OWNED AUTOS UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DIED I I RETENTION $ $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y/ N OFFICER/MEMBER EXCLUDED? ❑ (Mandatory in NH) N / A 4055092 01/01/2016 01/01/2017 X PER OTH- STATUTE ER E.L. EACH ACCIDENT $ 1,000,00 E.L. DISEASE - EA EMPLOYEE $ 1,000,00 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 1,000,00 A Auto Phy Damage A3231792 01/01/2016 01/01/2017 Comp Ded 50 Coll Ded 50 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) PEr policy terms conditions & exclusions Certificate Holder is an Additional Insured as respects General Liability, as required by written contract. Email: kmathea@fcgov.com l,tK I It -It -A I t MULUtK UANUtLLA I IUN FTCUTIL SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Fort Collins ACCORDANCE WITH THE POLICY PROVISIONS. Attn: Kaye Mathea PO Box 580 AUTHORIZED REPRESENTATIVE Ft Collins, CO 80522 00 „ � , ��� ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD