HomeMy WebLinkAbout169120 AIR COMFORT INC - INSURANCE CERTIFICATE (16)ACOROP CERTIFICATE OF LIABILITY INSURANCE
1111
DATE (MMlODlYYYY)
F
05125/2018
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 have ADDITIONAL INSURED provisions or 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 Jennifer Winter, CISR
NAME:
Flood and Peterson
PHONE -3206 FAX 970506-6846
A/C No Ezt : (970) 506 (A/C. No ()
E-MAIL JWnter@floodpeterson com
ADDRESS:
PO Box 578
INSURER(S) AFFORDING COVERAGE
NAIC #
INSURERA: Union Insurance Company of Providence
21423
Greeley CO 80632
INSURED
INSURER B : EMCASCO Insurance Company
21407
INSURER C : Employers Mutual Casualty Company
21415
Air Comfort, Inc.
INSURER D : Pinnacol Assurance
41190
150 Rome Court
INSURER E :
INSURER F :
Fort Collins CO 80524
COVERAGES CERTIFICATE NUMBER: CL1852523471 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAYBE 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
ALJUL
INSD
bUtSK
WVD
POLICY NUMBER
POLICY EFF
MMIDD/YYYY
POLICY EXP
MMlDD/YYYY
LIMITS
X
COMMERCIAL GENERAL LIABILITY
EACH OCCURRENCE
$ 1.000,000
CLAIMS -MADE � OCCUR
PREMISES Ea occurrence
$ 1,000,000
X
MED EXP (Any one person)
$ 10,000
PD DedA,000
PERSONAL & ADV INJURY
$ 1,000,000
A
5D8769619
06/01/2018
06/01/2019
GEN'LAGGREGATE LIMITAPPLIES PER.
GENERAL AGGREGATE
$ 2,000,000
POLICY PRO JECT � LOC
PRODUCTS - COMPIOPAGG
$ 2,000,000
$
OTHER
AUTOMOBILE
LIABILITY
CO MBINED SINGLE LIMIT
Ea accident
$ 1,000,000
X
BODILY INJURY (Per person)
$
ANY AUTO
B
OWNED SCHEDULED
AUTOS ONLY AUTOS
5E8769619
06/01/2018
06/01/2019
BODILY INJURY (Per accident)
$
X
PROPERTY DAMAGE
Per accident
$
HIRED NON -OWNED
AUTOS ONLY X AUTOS ONLY
$
X
UMBRELLA LIAB
X
OCCUR
EACH OCCURRENCE
$ 6,000,000
AGGREGATE
$ 6,000,000
C
EXCESS LIAB
CLAIMS -MADE
5J8769619
06/01/2018
06/01/2019
DED I X1 RETENTION $ 0
$
D
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY YIN
ANY PROPRIETORIPARTNER/EXECUTIVE
OFFICER/MEMBER EXCLUDED? F7N
(Mandatory In NH)
NIA
4041318
06/01/2018
06/01/2019
X ATUTE EORH
ST
E.L.EACH ACCIDENT
$ 1,000,000
E.L. DISEASE - EA EMPLOYEE
$ 1,000,000
If yes, describe under
DESCRIPTION OF OPERATIONS below
E.L. DISEASE - POLICY LIMIT
$ 1,000,000
DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
RE: Poudre Fire Authority #6, 102 Remington, Fort Collins. CO 80524
City of Fort Collins is listed as an Additional Insured as respects General Liability.
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
City of Fort Collins Accounting Department ACCORDANCE WITH THE POLICY PROVISIONS.
PO Box 580
AUTHORIZED REPRESENTATIVE
Fort Collins CO 80522-0580
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