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Home My WebLink About113664 JORDAN'S TREE MOVING & MAINTENANCE - INSURANCE CERTIFICATE (3)OP ID: TA ACoA 0 DATE(MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 03/01/2016 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 Phone: 970-223-1804 CONTACT NAME: Front Range Insurance Group Fax: PHONE FAX 1100 Haxton Drive Suite 100 AIC NoXtl: , _ A/C No): Fort Collins, CO 80525 E-MAIL ADDRESS: David A. Wooldridge LUTCFAAI PRODUCER JORDA-2 riicTnupo in ff• INSURER(S) AFFORDING COVERAGE NAIC # INSURED Jordan's Tree INSURERA: Secura Insurance Companies 22543 Moving & Maintenance, Inc INSURERS:Pinnacol Assurance 41190 1025 Smithfield Drive Fort Collins, CO 80524 INSURERC: INSURER D : INSURER E : INSURER F : !`!l\/FRAf_FC rFRTIFIrATF NIIMRFR• REVISION NUIMRFR: 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 IN POLICY NUMBER MMIDDfYYYY MM ODIYYYY LIMITS A A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE I OCCUR X Prof Liab X CP003250287-3 CP003250287-3 12/19/2015 12/19/2015 12/19/2016 12/19/2016 EACH OCCURRENCE $ 1,000,00 uAMAu E TO RENTED PREMISES Ea occurrence $ 300,00 MED EXP (Any one person) $ 10,00 PERSONAL & ADV INJURY $ 1,000,00 GENERALAGGREGATE $ 2,000,00 GEN'L AGGREGATE LIMIT APPLIES PER: 1-1 POLICY X PRO LOC PRODUCTS - COMP/OP AGG $ 2,000,00 Prof Liab $ 1,000,00 A AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS X 3200288 12/19/2015 12/19/2016 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,00 X BODILY INJURY (Per person) $ 5,0() X BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ X X $ UMBRELLA LIAB EXCESS LIAB HCLAIMS-MADE OCCUR EACH OCCURRENCE $ AGGREGATE $ DEDUCTIBLE RETENTION $ $ $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y ANY PROPRIETOR/PARTNER/EXECUTIVE F OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N / A 4040726 03/01/2016 03/01/2017 X WC STATU- OTH- TORY LIMITS ER E.L EACH ACCIDENT $ 1,000,00 E.L. DISEASE - EA EMPLOYE $ 1,000,00 E.L. DISEASE -POLICY LIMIT 1 $ 1,000,00 A Equipment Floater 34UUNSR3887 12/19/2015 12/19/2016 Leased 250,00 Ded 50 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) The City of Fort Collins, its officers, agents and employees are named as additional insured with regards to general and auto Liability. K"q;4112Lelt\Ia:Lei 4NgV CITY OF City of Fort Collins Puchasing Dept. 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 © 1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009/09) The ACORD name and logo are registered marks of ACORD