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HomeMy WebLinkAboutJANSMA BROS EXCAVATING & TRUCKING CORP - INSURANCE CERTIFICATE (5)JANSBRO-01 LPREWITT CERTIFICATE OF LIABILITY INSURANCE D 05 23/2018Y) 05123/2018 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 . NAME: PFS Insurance Group PHONE FAX 4848 Thompson Parkway Suite 200 A/C, No, Ext►: (970) 635-9400 (AIC, No :(970) 635-9401 Johnstown, CO 80534 IDJss: info@,mypfsinsurance.com INSURED Jansma Bros. Excavating & Trucking Corp. 1475 Backhoe Road Loveland, CO 80537 INSURER D : INSURER E : INSURER F : nnVFRAnFS r'.FRTIFIf`ATF MI IMRFR• GF\/I¢Ir1M MIIaaRCG• 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 ADDL Si POLICY NUMBER POLICY EFF POLICY EXP LIMITS A X I COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR Blanket Addl Insured PKGO9028303 04/01/2018 04/01/2019 EACH OCCURRENCE PAMAGESO aENTED RE $ 1,000,000 $ 100,000 $ 5,000 1,000,000 X MED EXP (Any one on X Blanket Waiver PERSONAL& ADV INJURY GEN'L AGGREGATE pLRIMpIT� APPLIES PER: POLICY ❑X JECT El LOC OTHER: GENERAL AGGREGATE 2,000,000 PRODUCTS - COMP/OP AGG 2,000,000 B AUTOMOBILE LIABILITY X ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS OWNED AUTOS ONLY AUTO ONLY X FIaurenVAddl X Blanket Waiver s 14E90700 04/01/2018 04/01/2019 COMBINED SINGLE LIMIT(Ea accident) 1,000,000 $ BODILY INJURY Perperson) $ BODILY INJURY Per accident PF20PERTY AMAGE eraccic;Z A X UMBRELLA LIAB EXCESSLIAB X i OCCUR CLAIMS -MADE I UMB019028404 04/01/2018 04/01/2019 EACH OCCURRENCE $ 1,000,000 AGGREGATE 19000,000 DED I X I RETENTION $ 10,000 C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y❑ QFFICER/MEMBER EXCLUDED? (MandatoryIn NHI If es, describe under DESCRIPTION OF OPERATIONS below N f A 2U2390 06/01/2018 X PTRT T ORH 06/01/2019 E.L_EACHACCIDENT E.L. DISEASE - EA EMPLOYE E.L. DISEASE - POLICY LIMIT 100,000 $ 1.00,000 500,000 IT I DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) ALL OPERATIONS - ALL LOCATIONS. City of Fort Collins P.O. Box 580 Fort Collins, CO 80522 Lel_6 L" a 4 W_\ 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 (2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD