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HomeMy WebLinkAboutASPEN ENTERPRISES OF NORTHERN COLORADO INC - INSURANCE CERTIFICATEASPEN-4 OP ID: DA ACORO' CERTIFICATE OF LIABILITY INSURANCE ATE (MM/DD/YYYY) r06/16/2017 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 Brown & Brown Inc 4532 Boardwalk Dr, Suite 200(MC,No Fort Collins, CO 80525 House Account CONTANAME: House Account PHONE 970-482-7747 FAX Et): No: 970-484-4165 E-MAIL ADDRESS: INSURERS AFFORDING COVERAGE NAIL # INSURER A: United Fire 8r Casualty Co. 13021 INSURED Aspen Enterprises of Northern INSURER B: Pinnacol Assurance Company 41190 Colorado, Inc. 504 Mail Creek Ct INSURER C:Old Republic Surety Company 404" Ft Collins, CO 80525 INSURERD: INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: 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. I�TR TYPE OF INSURANCE I INSD WVD POLICY NUMBER MMILDICA YY MM/ D//YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 CLAIMS -MADE � OCCUR X 60448507 07/01/2017 07/01/2018 DAMA To RENTED PREMISES Ea occurrence $ 100,00 MED EXP (Any one person) $ 6,00( PERSONAL & ADV INJURY $ 1,000,00 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,00 PRODUCTS - COMP/OP AGG $ 2,000,00 POLICY D PRO JECT LOC $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ 1,000,00 BODILY INJURY (Per person) $ A ANY AUTO 60448507 07/01/2017 07/01/2018 BODILY INJURY (Per accident) $ ALL OWNED SCHEDULED AUTOS AUTOS NON OWNED X HIREDAUTOS X AUTOS PROPER(DAMAGE racci $ $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE NOT COVERED DIED I I RETENTION $ $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y / N 4038548 07/01 /2017 07/01/2018 PER OTH- X STATUTE ER E.L. EACH ACCIDENT $ 500,00 OFFICER/MEMBER EXCLUDED? ❑ (Mandatory in NH) N / A E.L. DISEASE - EA EMPLOYEE $ 500,00 E.L. DISEASE - POLICY LIMIT $ 500,0() If yes, describe under DESCRIPTION OF OPERATIONS below I C Crime I W150196966 07/01/2017 07/01/2018 Crime 10,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Janitorial Services - Poudre Fire Authority, Buildings A&B, 3400 W Vine, Fort Collins, CO 80521 - City of Fort Collins is included as Additional Insured per policy forms and Conditions See Notes (:tK 1 IFIL:A I t HULUtK l.H1V liCLLH I IVIY CITYF10 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Fort Collins ACCORDANCE WITH THE POLICY PROVISIONS. Purchasing AUTHORIZED REPRESENTATIVE 215 N. Mason St. / Fort Collins, CO 80521 �� V © 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD ASPEN-4 PAGE 2 NOTEPAD INSURED'S NAME Aspen Enterprises of Northern OP ID: DA Date 06/16/2017 When Required by written contract the following applies: General Liability - CG7151 0215 Automatic Additional Insured - Owners, Lessees or Contractors Automatic Additional Insured - Vendors Automatic Additional Insured - Lessor of Leased Equipment Automatic Additional Insured - Managers or Lessors of Premises Automatic Additional Insured - Employee Injury to another employee Per Project Aggregate Per Location Aggregate ASPEN-4 OP ID: DA ACORO' CERTIFICATE OF LIABILITY INSURANCE ATE (MM/DD/YYYY) r06/16/2017 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 Brown & Brown Inc 4532 Boardwalk Dr, Suite 200 Fort Collins, CO 80525 House Account CONTACT NAME: House Account PHONE 970-482-7747 FAX No: 970-484-4165 A/C No Ext: E-MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: United Fire & Casualty Co. 13021 INSURED Aspen Enterprises of Northern INSURER B : Pinnacol Assurance Company 41190 Colorado, Inc. 504 Mail Creek Ct INSURER C:Old Republic Surety Company 40444 Ft Collins, CO 80525 INSURERD: INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: 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 TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF MMIDD/YYYY POLICY EXP MM/DD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 CLAIMS -MADE Al OCCUR X 60448507 07/01/2017 07/01/2018 DAMAGE TO RENTED PREMISES Ea occurrence $ 1 OO, OO MED EXP (Any one person) $ 5,00 PERSONAL & ADV INJURY $ 1,000,00 GENT AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,00 PRO - POLICY PRO ❑ JECTLOC PRODUCTS - COMP/OP AGG $ 2,000,00 $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ 1,000,00 BODILY INJURY (Per person) A ANY AUTO 60448507 07/01/2017 07/01/2018 $ BODILY INJURY (Per accident) $ ALL OWNED SCHEDULED AUTOS AUTOS X X NON -OWNED HIRED AUTOS AUTOS PROPERTY DAMAGE Peraccident $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ _ EXCESS LIAB CLAIMS -MADE NOT COVERED DED I I RETENTION $ $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y❑ ii4038548 07/01/2017 07/01/2018 X STATUTE ER H E.L. EACH ACCIDENT $ 500,000 OFFICER/MEMBER EXCLUDED? (Mandatory in NH) N / A E.L. DISEASE - EA EMPLOYEE _- -- --- - $ 500,00 E.L. DISEASE - POLICY LIMIT $ 500,000 If yes describe under DESCRIPTION OF OPERATIONS below C Crime W150196966 07/01/2017 i 07/01/2018 Crime 10,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Janitorial Services - Poudre Fire Authority, 102 Remington, Fort Collins, CO 80521 - City of Fort Collins is included as Additional Insured per policy forms and Conditions See Notes CITYF10 City of Fort Collins Purchasing 215 N. Mason St. Fort Collins, CO 80521 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 ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD ASPEN-4 PAGE 2 NOTEPAD INSURED'S NAME Aspen Enterprises of Northern OP ID: DA Date 06/16/2017 When Required by written contract the following applies: neral Liability - CG7151 0215 tomatic Additional Insured - Owners, Lessees or Contractors tomatic Additional Insured - Vendors tomatic Additional Insured - Lessor of Leased Equipment tomatic Additional Insured - Managers or Lessors of Premises tomatic Additional Insured - Employee Injury to another employee r Project Aggregate r Location Aggregate ASPEN-4 OP ID: DA ACORO" CERTIFICATE OF LIABILITY INSURANCE ATE (MMlDDlYYYY) TE(MMI D/YY r017 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 Brown & Brown Inc 4532 Boardwalk Dr, Suite 200 Fort Collins, CO 80525 House Account NAME CT House Account _ PHONE FAX tac No Ext :970-482-7747 Alc, No): 970-484-4165 E-MAIL ADDRESS: INSURERS AFFORDING COVERAGE NAIC # INSURER A: United Fire & Casualty Co. 13021 INSURED Aspen Enterprises of Northern INSURER B : Pinnacol Assurance Company 41190 Colorado, Inc. 504 Mail Creek Ct INSURER C:Old Republic Surety Company 40444 Ft Collins, CO 80525 INSURERD: INSURER E : INSURER F : CnVFRAGFS CERTIFICATE NUMBER: 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 TYPE OF INSURANCE ADDLi�SUBRI. INSD WVD'! POLICY NUMBER 1 POLICY EFF MM/DDIYYYY POLICY EXP MMIDD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 CLAIMS -MADE � OCCUR X 60448507 07/01/2017 07/01/2018 DAMAGE TO RENTED PREMISES Ea occurrence $ 100,00 MED EXP (Any one person) $ 5,00 PERSONAL & ADV INJURY $ 1,000,00 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,00 POLICY PRO JECT ❑ LOC PRODUCTS - COMP/OP AGG $ 2,000,00 $ OTHER AUTOMOBILE LIABILITY COEa cidentMBINED SINGLE LIMIT ac $ 1,000,000 BODILY INJURY (Per person) $ A ANY AUTO 60448507 07/01/2017 07/01/2018 BODILY INJURY (Per accident) $ -- ALL OWNED SCHEDULED AUTOS AUTOS NON-OWNED X HIRED AUTOS X AUTOS PER PeraccidenDAMAGE $ -- UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LAB CLAIMS -MADE NOT COVERED DED RETENTION $ $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE YIN 4038548 07/01/2017 07/01/2018 X PER OTH- STATUTE ER E.L. EACH ACCIDENT $ 500,000 E.L. DISEASE - EA EMPLOYEE $ 500,00 OFFICER/MEMBER EXCLUDED? (Mandatory in NH) N / A E.L. DISEASE - POLICY LIMIT If yes, describe under DESCRIPTION OF OPERATIONS below $ 500,00 C Crime W150196966 07/01/2017 07/01/2018 Crime 10,000 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Janitorial Services - Poudre Fire Authority Prevention -102 Remington, Fort Collins, CO 80521 - City of Fort Collins is included as Additional Insured per policy forms and Conditions See Notes CITYF10 L7L\ C L9-1 El WIN ILWA LI SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of Fort Collins Purchasiong 215 N. Mason St. Fort Collins, CO 80521 AUTHORIZED REPRESENTATIVE, / (� © 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD ASPEN-4 PAGE 2 NOTEPAD INSURED'S NAME Aspen Enterprises of Northern OP ID: DA Date 06/16/2017 When Required by written contract the following applies: General Liability - CG7151 0215 Automatic Additional Insured - Owners, Lessees or Contractors Automatic Additional Insured - Vendors Automatic Additional Insured - Lessor of Leased Equipment Automatic Additional Insured - Managers or Lessors of Premises Automatic Additional Insured - Employee Injury to another employee Per Project Aggregate Per Location Aggregate