HomeMy WebLinkAboutROCKY MOUNTAIN TREE SERVICE - INSURANCE CERTIFICATE (3)--� "N ROCKMOU-33 LPREWITT
.4COR" DATE (MM/DDlYI'YY)
��.. CERTIFICATE OF LIABILITY INSURANCE 11/5/2015
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
NAME:
PFS Insurance Group PHONE FAX
4848 Thompson Parkway Suite 200CA/C.
A/C No Ext : (970) 635-9400 A/C No): (970) 635-9401
Johnstown, CO 80534 E-MAIL ADDRESS: �YP
info m fsinsurance.com
INSURED
Rocky Mountain Tree Service
Mark Berard
PO Box 1334
Loveland, CO 80539
COVERAGES
CERTIFICATE NUMBER:
INSURER(S) AFFORDING COVERAGE NAIC #
INSURER A: Burlington Insurance Company
INSURER B :
INSURER C :
INSURER D :
INSURER E :
INSURER F
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 TYPE OF INSURANCE POLICY EFF POLICY EXP LIMITS
LTR I WVD POLICY NUMBER MM/DD/YYYY MM/DDIYVYY
A
X
COMMERCIAL GENERAL LIABILITY
EACH OCCURRENCE
$ 1,000,00
CLAIMS -MADE a OCCUR
X
251B004529
11/04/2015
11/04/2016
DAMAGE
PREMISES Ea occurrence
_
$ 100,00
MED EXP (Any one person)
$ 5,00
PERSONAL 8 ADV INJURY
$ 1,000,000
GEN'LAGGREGATE LIMIT APPLIES PER:
GENERAL AGGREGATE
$ 2,000,00
POLICY 7PE� LOC
PRODUCTS - COMP/OP AGG
$ 2,000,00
$
OTHER:
AUTOMOBILE LIABILITY
COMBINED SINGLE LIMIT
Ea accident
$
BODILY INJURY (Per person)
$
ANY AUTO
ALL OWNED SCHEDULED
AUTOS AUTOS
BODILY INJURY (Per accident)
$
PROPERTY DAMAGE
Per accident)
$
NON -OWNED
HIRED AUTOS AUTOS
$
UMBRELLA LIAB
OCCUR
EACH OCCURRENCE
$
AGGREGATE
$
EXCESS LIAB
CLAIMS -MADE
DED RETENTION $
$
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY Y / N
PER OTH-
STATUTE I I ER
E.L. EACH ACCIDENT
$
ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICER/MEMBER EXCLUD? DE
NIA
E.L. DISEASE - EA EMPLOYE
$
(Mandatory in NH)
If yes, describe under
DESCRIPTION OF OPERATIONS below
E.L. DISEASE - POLICY LIMIT
$
DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
Tree Trimming and service
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SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
City Of Fort Collins THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
Attn: Sarah
PO Box 580/215 N. Mason 3rd FI
Ft Collins, CO 80522 AUTHORIZED REPRESENTATIVE
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