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304369 CONTINENTAL HARDSCAPE SYSTEMS LLC - INSURANCE CERTIFICATE (3)
/ A� " CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 12/23/2017 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 Javier Perez NAME: PHCC0 No Ext: (970)356-0123 A/C NO: (970)330-1867 E-MAIL JPerez@F1oodPeterson.com ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC it INSURERAMestfield Insurance Company 24112 INSURED Continental Hardscape Systems, LLC 6401 E 72nd Avenue Suite 105 Commerce City CO 80022 INSURERB:Pinnacol Assurance 41190 INSURERC: INSURER D : INSURER E : INSURERF: COVERAGES CERTIFICATE NUMBER-CL17122321164 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 ADDL SUER POLICY NUMBER POLICY EFF MMIDDNYYY POLICY EXP MMIDDIYYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A CLAIMS -MADE F OCCUR AMAG O RENTED500,000 PREMISES Ea occurrence $ MED EXP (Any one person) $ 5,000 CWPIS17099 7/17/2017 7/17/2018 PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY PE� LOC PRODUCTS - COMPiOPAGG $ 2,000,000 $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ 1,000,000 BODILY INJURY (Per person) $ A ANY AUTO X ALL OWNED SCHEDULED AUTOS AUTOS NON -OWNED X HIRED AUTOS LAUTOS CWP1817099 7/17/2017 7/17/2018 BODILY INJURY (Per accident) $ PROPERTY DAMAGE Peraccid I — $ Medical payments $ 5,000 X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 5,000,000 AGGREGATE $ 5,000,000 A EXCESS LIAB CLAIMS -MADE DED I X I RETENTION$ 0 $ CWP1817099 7/17/2017 7/17/2018 B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOPJPARTNEPJEXECIITIVE OFFICER/MEMBER EXCLUDED? ❑Y (Mandatory in NH) N / A 4179574 1/1/2018 1/1/2019 X P - STATUTE ER EL 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 A Leased/Rented Equipment CWPl017099 7/17/2017 7/17/2018 Limit $ 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 listed as an Additional Insured as their interest may appear as respects General Liability, for ongoing operations only. Insurance is primary and non-contributory. CERT!F!CATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Fort Collins PO Box 580 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Fort Collins, CO 80522-0000 AUTHORIZED REPRESENTATIVE Javier Perez/.32EREZ ACORD 25 (2014101) INS025 onunn ©1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD