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Home My WebLink About361699 ZAK GEORGE LANDSCAPING - INSURANCE CERTIFICATE (5),4Ro® CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 03/20/2018 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 Kylie Carey, CISR, CIC NAME: Flood and Peterson A �NfVo. Ext : (970) 266-7148 A No : (970) 506-6845 PO Box 578 E-MAIL KCarey@floodpeterson.com ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: Cincinnati Indemnity Cc 23280 Greeley CO 80632 INSURED INSURER B : Plnnacol Assurance 41190 INSURER C : Zak George Landscaping, LLC INSURER D : 335 S. Summit View Drive INSURER E: INSURER F: Fort Collins CO 80524 COVERAGES CERTIFICATE NUMBER: CL1832022495 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. INSR LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER POLICY EFF MM/DD/VYYY POLICY EXP MM/DD/YYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE � OCCUR PREMISES Ea occurrence $ 500, 000 X MED EXP (Any one person) $ 10,000 PD Ded.: $1,000 PERSONAL & ADV INJURY $ 1,000,000 A EPP0472465 04/01/2018 04/01/2019 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY � JECT PRO El PRO- PRODUCTS - COMP/OP AGG $ 2,000,000 WYSG $ 1,000,000 OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident $ 1,000,000 BODILY INJURY (Per person) $ X ANY AUTO A OWNED SCHEDULED AUTOS ONLY AUTOS EPP0472465 04/01/2018 04/01/2019 BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident $ HIRED NON -OWNED X AUTOS ONLY X AUTOS ONLY Medical payments s 5,000 X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 5,000,000 AGGREGATE $ 5,000,000 A EXCESS LIAB CLAIMS -MADE EPP0472465 04/01/2018 04/01/2019 DED I I RETENTION $ S B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y/N ANY PROPRIETOR/ AXECUTIVE OFFICER/MEMBER EXCLUDED.CLUDED? E (Mandatory in NH) N / A 4103537 04/01/2018 04/01/2019 OTH- X PERUTE STATER 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 $ A Leased/Rented Equipment EPP0472465 04/01/2018 04/01/2019 $50,000 Limit $2,500 Deductible DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Certificate holder is included as Additional Insured as required by written contract with respects to liability arising out of work performed by the named insured, with respect to the General Liablity and Auto Liability policies. The City of Fort Collins Purchasing Department P.O. Box 580 Fort Collins CO 80522 t,APIl.GLLFI I IUIV 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 @ 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD