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HomeMy WebLinkAbout108976 L & M ENTERPRISES INC - INSURANCE CERTIFICATE (5)C� © DATE (MM/DD/YYYY) A CC CERTIFICATE OF LIABILITY INSURANCE 12/2e/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 CONTACT Renee McReynolds NAME: y Ewing -Leavitt Insurance Agency PHONrE EX (970) 679-7344 FAIL No: (866)425.6180 4025 St. Cloud Dr. ADDRIESS:renee-mcReynolds@leavitt.com Suite 100 INSURERS AFFORDING COVERAGE NAIL # Loveland CO 80538 INSURERA:Cincinnati Insurance Co 10677 INSURED INSURER B :Pinnacol Assurance 41190 L & M Enterprises, Inc. INSURERC: 735 E Highway 56 INSURERD: P O BOX W INSURER E : _ Berthoud CO 80513 INSURER F : COVERAGES CERTIFICATE NUMBER:16-17 REVISION NIJMBER7 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. INTR R TYPE OF INSURANCE iNgn wyn SUER POLICY NUMBER MM DDY EFF Y EXP MM DD LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A CLAIMS -MADE I X OCCUR DAMAGE TO RENTED PREMISES Ea occurrence $ 500,000 X MED EXP (Any one person) $ 10,000 Blanket WOS X ENP0224898 1/1/2016 1/1/2017 x Blanket Addl Insureds PERSONAL BADVINJURY $ 1,000,000 GEML AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 Additional Insured form POLICY ❑X PRO ❑ LOC JEC7 includes ongoing and PRODUCTS -COMP/OP AGG $ 2,000,000 $ OTHER: completed operations AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ 1, 000 , 000 X BODILY INJURY (Per person) $ A ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS X ENP0224898 1/1/2016 1/1/2017 BODILY INJURY Per accident ( ) $ X PROPERTY DAMAGE Per accident $ NON - OWNED AUTOS HIRED AUTOS �Xx X $ Blkt WOS Blkt Addl Insureds X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 4,000,000 AGGREGATE $ 4,000,000 A EXCESS LIAB CLAIMS -MADE DIED X RETENTION$ 0 $ ENP0224898 1/1/2016 1/1/2017 B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) NIA incl Blanket Waiver of Subrogation endt 4188429 1/1/2016 1/1/2017 PER OTH- X STATUTE ER E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1, 00 0 000 90 If es, describe under DESCRIPTION OF OPERATIONS below — E.L. DISEASE - POLICY LIMIT $ 11000,000 A Contractors' Equipment ENP0224898 1/l/2016 1/l/2017 Leased/Rented Equipment $85,000 Installation Fltr $150,000limit $1000 deduct DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) re: BID 8095 Weed Cutting & Rubbish Removal; Certificate holder, its officers, agents and employees are named additional insured as respects both general and auto liability policies. The insurance evidenced by this certificate will not reduce coverage or limits and will not be cancelled except after thirty (30) days written notice has been received by the certificate holder. City of Fort Collins Attn: Purchasing Dept P O Box 580 Fort Collins, CO 80522 CANCELLATION 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 McReynolds/RESTEI��i11nOe�� © 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD INS025 (201401)