HomeMy WebLinkAboutKAHAR PLUMBING & HEATING INC - INSURANCE CERTIFICATE (13)f®
A�RL) CERTIFICATE OF LIABILITY INSURANCE
DATE (MM/DD/YYYY)
05/18/2018
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
Flood and Peterson
Corporate Mailing Address:
P.O. BOX 578
Greeley CO 80632
CONTACT NAME: Bnanne Danielson, CISR
PHOA/CNNo Ext : (970) 266 7118 A/CFAX,..): (970) 506-6846
E-MAIL s: BDanielson@FloodPeterson.com
ADDRE
INSURER(S) AFFORDING COVERAGE
NAIC M
INSURER A: Acadia Insurance Company
31325
INSURED
Kahar Plumbing & Heating, Inc.
6772, 6766 & 6760 N. Franklin Avenue
Loveland CO 80538
INSURER B: Pinnacol Assurance
41190
INSURER C :
INSURER D:
INSURER E :
INSURER F:
rnveonnce r`FRTIPICATF NI IIURFR• CL1851823314 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.
1
LTR
TYPE OF INSURANCE
INSD
WVD
POLICY NUMBER
MM/DDJYYYY
MM/DD/YYYY
LIMITS
A
X
COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE F OCCUR
$1,000 Deductible - Property
CPA306323024
05/19/2018
05/19/2019
EACH OCCURRENCE
$ 1,000,000
PREMISES Ea occurrence
$ 300,000
X
MED EXP (Any oneperson)
$ 10,000
Damage - Per Occurrence
PERSONAL& ADV INJURY
$ 1,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
POLICY 19 JE oT LOC
OTHER:
GENERAL AGGREGATE
$ 2'000'000
PRODUCTS - COMP/OP AGG
$ 2,000,000
$
A
AUTOMOBILE LIABILITY
X ANY AUTO
OWNED SCHEDULED
AUTOS ONLY AUTOS
HIRED NON -OWNED
X AUTOS ONLY IXAUTOS ONLY
CPA306323024
05/19/2018
05/19/2019
COMBINED SINGLE LIMIT
Ea accident
$ 1,000,000
BODILY INJURY (Per person)
$
BODILY INJURY (Per accident)
$
PROPERTY DAMAGE
Per accident
$
A
X
UMBRELLA LIAR
EXCESS LIAB
X
OCCUR
CLAIMS -MADE
CPA306323024
05/19/2018
05/19/2019
EACH OCCURRENCE
$ 1,000,000
AGGREGATE
$ 1,000,000
DED I X1 RETENTION $ 0
1
$
B
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY v / N
ANY PROPRIETOR/PARTNER/EXECUTIVE ECUTIVE [--I
OFFICER/MEMBER EXCLUDED.
(Mandatory in NH)
If yes, describe under
DESCRIPTION OF OPERATIONS below
N / A
1542230
07/01/2017
07/01/2018
PER OTH-
X STATUTE ER
E.L. EACH ACCIDENT
$ 500,000
E.L. DISEASE - EA EMPLOYEE
$ 500,000
E.L. DISEASE - POLICY LIMIT
$ 500,000
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required)
Certificate holder is named as additional insured (Excluding workers compensation).
FE HOLDER
City of Fort Collins Utilities
PO BOX 440
Fort Collins
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORRED REPRESENTATIVE
CO 80522-0000 1 `30,ut anie-&OtV.
V 19t5tl-ZU1b AGVHU GVHYVFIA I IVI I. All ngrns reservcv.
ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD