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Home My WebLink About120528 FORT COLLINS TREE CARE INC - INSURANCE CERTIFICATE (12)-� FORTCOL-09 CEVIG ACORO D/YYYY) E (MM/D CERTIFICATE OF LIABILITY INSURANCE DATE 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' Angela Gross TrueNorth PHONE FAX PO Box 847 (A/c, No 010: (303) 776-5122 (A/c, No): (303) 776-5495 Longmont, CO 80502 E-MAIL INSURED Fort Collins Tree Care, Inc 301 East Douglas Road Fort Collins, CO 80524 INSURERS) AFFORDING COVERAGE NAM INSURER A: Twin City Fire Insurance Company 29459 INSURER B : Pinnacol Assurance Company 41190 INSURER C INSURER E : INSURER F : nnVFRAhFS CFRTIFICATF NIIMRFR- 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 - - --- — ADDLSUBR'- - POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER MM/DDIYYYY MM/DD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 X OCCUR 34UUNSR3900 03/05/2016 03/05/2017 AMAGE TOCLAIMS-MADE PREM SES EaENTEoccurrence) $ 300,000 MED EXP (Any one person) $ 10,000 PERSONAL it ADV INJURY $ 1,000,00 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 PRO - POLICY X ECT LOC PRODUCTS - COMP/OP AGG $ 2,000,00 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Eaaccdent) $ 1000,000 i A X ANY AUTO 34UUNSR3900 03/05/2016 03/05/2017 BODILY INJURY (Per person) ! $ $ ALL OWNED SCHEDULED BODILY INJURY (PeraccideM) AUTOS AUTOS $ X X NON-OWNED PROPERTY HIRED AUTOS AUTOS CP Per MO)_ _ $ UMBRELLA LIAR OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS -MADE AGGREGATE _ $ $ DED RETENTION $ WORKERS COMPENSATION X PER OTH- STATUTE ER AND EMPLOYERS' LIABILITY B ANY PROPRIETOR/PARTNER/EXECUTIVE YIN 4148327 05/01/2016 05/01/2017 _ E.L. EACH ACCIDENT j$ 100,000 OFFICER/MEMBER EXCLUDED? N/A 100,000 (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE $ If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) City of Fort Collins as Additional Insured as required by written contract per General Liability policy form. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City Of Fort Collins THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ty ACCORDANCE WITH THE POLICY PROVISIONS. Purchasing Division P O Box 580 Fort Collins, CO 80522 AUTHORIZED REPRESENTATIVE �BA�M D' 0aVL,- ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD