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Home My WebLink About107133 BATH INC - INSURANCE CERTIFICATE (14)ACOOR 0® CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 10/26/2017 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 Flood and Peterson PO Box 578 Greeley CO 80632 CONTACT Jennifer Winter, CISR NAME: PHONE (970)506-3206 Fa No:(970)506-6846 ADE-M�RESS:JWinter@floodpeterson.com INSURERS AFFORDING COVERAGE NAIC # INSURERA:Union Insurance Company 25844 INSURED Bath, Inc. 2000 E . Prospect Road Fort Collins CO 80525 INSURER B :Pinnacol Assurance 41190 INSURER C : INSURER D : INSURER E : INSURER F OVERAGES CERTIFICATE NUMBER:CL17102620280 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 A UBR POLICY NUMBER MM/DDNLICY YYV POLICY M DDNYYY LIMITS X -lu11 COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A CLAIMS -MADE ❑X OCCUR ccuence PREMISES Ea occurrence) $ 300,000 X MED EXP (Any one person) $ 10,000 PD Ded: 500 CPA315208421 11/1/2017 11/1/2018 PERSONAL & ADV INJURY $ 1,000,000 GENT AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP/OP AGG $ 2,000,000 POLICY I JE T LOC $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ 1,000,000 BODILY INJURY (Per person) $ A X ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS NON -OWNED X HIRED AUTOS X AUTOS CPA315208421 11/1/2017 11/1/2018 BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ $ X Drive Other Car X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 5,000,000 AGGREGATE $ 5 000,000 A LIAB CLAIMS -MADE 1:4EXCESS DED I X I RETENTION$ 0 $ CPA315208421 11/1/2017 11/1/2018 B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? � (Mandatory in NH) NIA 4015110 11/1/2017 11/1/2018 }[ STATUTE ER E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE -POLICY LIMIT $ 1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) RE: Neighborhood Street Tree Replacement #7205 City of Fort Collins, its officers, agents, and employees are listed as Additional Insureds as respects General Liability, including completed operations, and Auto Liability. Insurance is primary and non-contributory. GE City of Fort Collins PO Box 580 Fort Collins, CO 80521 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 J Winter, CISR/JWINTE ACORD 25 (2014/01) INS025 onl4mi U 1988-2014 AGUKU GUKPUKA I IUN. All rlgnts reserved. The ACORD name and logo are registered marks of ACORD