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HomeMy WebLinkAbout117224 HORIZON MECHANICAL SOLUTIONS - INSURANCE CERTIFICATE (5)AC"R " CERTIFICATE OF LIABILITY INSURANCE ATE D3/31/2016Y) 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: Whitneyg Morgan, CLCS, CISR Flood and Peterson PHONE (970)356 EXO:-0123 A/C No: (970)330-1867 E-MAIL ADDRESS: g WMor an@floodP eterson.com PO Box 578 INSURERS AFFORDING COVERAGE NAIC # INSURERA:Union Insurance Company 25844 Greeley CO 80632 INSURED INSURERB:Pinnacol Assurance 41190 INSURER C: Horizon Mechanical Solutions Dba Horizon Sheet Metal, Inc INSURERD: INSURER E : 126 Hemlock Fort Collins CO 80524 INSURER F: COVERAGES CERTIFICATE NUMBER:CL1632909895 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 I TYPE OF INSURANCE ADDL SUBR wyn POLICY NUMBER POLICY EFF MM/DD/YYYV POLICY EXP MM/DD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE X OCCUR EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED PREMISES Eaoccur,ance $ 100,000 VIED EXP (Any one person) $ 51000 X CPA312869720 4/1/2016 4/1/2017 PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRO- X POLICY PRO JECT LOC GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP/OP AGG $ 2,000,000 Employee Benefits $ 1,000,000 OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ 1,000,000 X BODILY INJURY (Per person) $ A ANY AUTO ALLOWNED SCHEDULED AUTOS AUTOS CPA312869720 4/1/2016 4/1/2017 BODILY INJURY Per accident ( ) $ HIRED AUTOS NON -OWNED AUTOS PROPERTY DAMAGE Per accident $ $ X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 4,000,000 AGGREGATE $ 4,000,000 A EXCESS LAB CLAIMS -MADE CPA312869720 4/1/2016 4/1/2017 DIED I X RETENTION$ 0 $ B(MandatoryF WORKERS COMPENSATION AND EMPLOYERS'LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE in NH MBER EXCLUDED? ) If yes, describe under DESCRIPTION OF OPERATIONS below NSA 4009379 4 1/2016 / 4/1/2017 X PER H- STATUTE ER E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE - POLICY LIMIT $ 11000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Certificate holder is included as Additional Insured as required by written contract with respects to liability arising out of work performed by the named insured. CERTIFICATE HOLDER CANCELLATION City of Fort Collins P.O. 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 ACORD 25 (2014/01) Morgan, CLCS, CISR/ © 1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD