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Home My WebLink About165318 CMS MECHANICAL SERVICES INC - INSURANCE CERTIFICATE (8)CMSME-1 OP ID: JD AC4JRO DATE (MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE F04/03/2018 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 CONTANAME: Jody Wagner Brown 8, Brown Inc PHONE g70-482-7747 FAX 4532 Boardwalk Dr, Suite 200 lA/c.IN E,1: (A/C, No): 970-484-4165 Fort Collins, so525 William S. Richh ADDRESS: jwagner@bbcolorado.com INSURER A: Depositors Insurance Company 42587 INSURED CMS Mechanical Services, Inc. INSURER B: AMCO Insurance Company _ _ 19100 609 Technology Circle, Suite A Windsor, CO 80550 INSURER c:Pinnacol Assurance Company 41190 INSURER D : Nationwide Mutual Insurance Co 23787 INSURER E : Philadelphia Indemnity Ins Co 18058 INSURER F : r 0VFRAr;FS CFRTIFICATF NIIMRFR- RFVI-RlON NLIMRFR- 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 DL US POLICY EFF POLICY EXP LIMITS LTR I W POLICY NUMBER MM/DD/YYYY MM/DD/YYYY A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 CLAIMS -MADE I '� � OCCUR X CPGLD03046558176 04/27/2018 04/27/2019 PREMISESEMISES EE(REATED a occurrence $ 100,00 X MED EXP (Any one person) $ 10,000 E Employment Pract PHSD1266357 07/18/2017 07/18/2018 (Intl 3rd Party) PERSONAL & ADV INJURY $ 1,000,00 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,00 POLICY jE LOC $ 2,000,000 PRODUCTS - COMP/OP AGG OTHER: EPL Limit $ 1,000,000 AUTOMOBILE LIABILITY COMBINED Ea accident SINGLE LIMIT $ 1,000,000 BODILY INJURY (Per person) A X ANY AUTO X ACPBAPD3046558176 04/27/2018 04/27/2019 $ ALL OWNED SCHEDULED AUTOS AUTOS NON -OWNED HIRED AUTOS AUTOS L BODILY INJURY (Per accident) $ _ $ PROPERTY DAMAGE Per accident $ X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 2,000,000 $ 2,000,00 B EXCESS LIAR CLAIMS -MADE ACPCAA3046558176 04/27/2018 04/27/2019 AGGREGATE DIED I X I RETENTION $ 0 $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY IN ANY PROPRIETOR/PARTNER/EXECUTIVE Y� OFFICER/MEMBER EXCLUDED? (Mandatory in NH) N A 1055092 06/01/2016 06/01/2019 X STATUTE ER E.L. EACH ACCIDENT $ 1,000,00 E.L. DISEASE - EA EMPLOYEO $ 1,000,00 i f Yes, desoribe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 1,000,000 D Installation Fltr ACPCIM3046558176 04/27/2018 04/27/2019 Inst Fltr 50,000 Lsd/Rntd Equip Lsd/Rtd 50,000 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space is required) City of Fort Collins is included as an additional insured per forms and conditions on page 2. !`C0TICI1-ATC WP1l n=D CAMCFI I ATIr1M CITYFT5 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 Purchasing P. O. Box 580 AUTHORIZED REPRESENTATIVE Fort Collins, CO 80521 U 19BB-ZU14 AUUKU UUKPUKA I IUN. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD NOTEPAD CM INSURED'S NAME CMS Mechanical Services, Inc. OP ID: D: JD The following apply when required by written contract: ENERAL LIABILITY: dditional Insured On -going & Completed Operations CG7246 11/15 rimary/Non-Contributory Wording CG7246 11/15 lanket Waiver of Subrogation CG7158 08/04 er Project Aggregate CG2503 05/09 UTOMOBILE LIABILITY: dditional Insured AC7005 (03/16) lanket Waiver of Subrogation AC7005 (03/16) RELLA LIABILITY: lowing form ORRERS' COMPENSATION: lanket Waiver of Subrogation 359-B Contractor, Owners, Architect and the Architects consultants are luded as Additional Insureds as respect to Automobile Liability, the Liability is primary & non- contributory only if required by written tract, the WC and General Liability policies include a Waiver of rogation in favor of the addl insureds only if required by written tract, and all are subject to the forms and conditions listed on page PAGE 2 Date 04/03/2018