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HomeMy WebLinkAbout124948 TOP GYN PRESSURE WASHING INC - INSURANCE CERTIFICATE (2)ACORO® CERTIFICATE OF LIABILITY INSURANCE `..►-� DATE(MM/DD/YYYY) 6/29/2018 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 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 Olson & Olson Ltd 5655 S. Yosemite St. #200 Greenwood Village CO 80111 CONTACT NAME: PHONE FAX /C No): 303-867-2074 A/C No Ext : 303-867-2055 A/C. ADDRESS: o2@olsonandolson.com INSURERS AFFORDING COVERAGE NAIC # INSURER A: Pinnacol Assurance 41190 INSURED TOPGU-1 INSURER B: Westfield Insurance Company 24112 Top Gun Pressure Washing, Inc. 500 W. 67th St. INSURER c INSURER D : Loveland CO 80538 INSURER E INSURER F : COVERAGES CERTIFICATE NUMBER: 618715442 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. POLICY EFF POLICY EX�P INSR ADDLTYPE OF INSURANCE INSR SUER POLICY NUMBER MM/ D/YYYY MM LTR /DD/YYYY LIMITS B GENERAL LIABILITY TRA6418137 7/1/2018 7/1/2019 EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED PREMISES Ea occurrence $100,000 MED EXP (Any one person) $10,000 CLAIMS -MADE [ X i OCCUR PERSONAL & ADV INJURY $1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2,000,000 $ POLICY X PRO- LOC B AUTOMOBILE LIABILITY TRA6418137 7/1/2018 7/1/2019 COMBINED SINGLE LIMIT Ea accident 1 000 000 BODILY INJURY (Per person) $ X ANY AUTO BODILY INJURY (Per accident) $ ALL OWNED SCHEDULED AUTOS AUTOS PROPERTY DAMAGE Per accident) $ NON -OWNED X X HIRED AUTOS AUTOS B X UMBRELLA LAB X OCCUR TRA6418137 7/1/2018 7/1/2019 EACH OCCURRENCE $ 5,000,000 AGGREGATE $ 5,000,000 EXCESS LIAB CLAIMS -MADE DED I X RETENTION $ N/A $ A WORKERS COMPENSATION 4031609 7/1/2018 7/1/2019 X WE sTATU- OTH- AND EMPLOYERS' LIABILITY Y / N ANY OFFICER/MEMBEER/EXCLUDED> ECUTIVE � N / APARTNER/EX - E.L. EACH ACCIDENT $ 1,000,000 (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE $1,0001000 E.L. DISEASE - POLICY LIMIT $ 1,000,000 It yes, describe under DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) Certificate Holder and those listed below (if any) are Additional Insureds as respects General Liability and Umbrella Liability on a Primary and Non -Contributory basis, and Auto Liability only if required by written contract or agreement and coverage applies only as respects work performed by the Insured for the Additional Insureds. All coverage terms, conditions, and exclusions of the policy apply. The Worker's Compensation, General Liability, Auto Liability, and Umbrella Liability policies include a Waiver of Subrogation in favor of the Additional Insureds only if required by written contract or agreement. Contract Work. Old Town downtown sidewalk & Pavement area. CERTIFICATE HOLDER L;ANL;tLLA I IUN City of Fort Collins Purchasing Division PO Box 580 Fort Collins CO 80522-0580 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 © 1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD