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HomeMy WebLinkAbout113664 JORDAN'S TREE MOVING & MAINTENANCE INC - INSURANCE CERTIFICATE (6)OP ID: SC 'a�oRo CERTIFICATE OF LIABILITY INSURANCE 7MM/DD1YYYY) ;13/2017 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). CONTACT PRODUCER Phone: 970-223-1804 NAME: Front Range Insurance Group PHONE FAX 2002 Caribou Drive, Ste. 101 Fax: 1AJC, No Ext : Arc, No): Fort Collins, CO 80525 E-MAIL David A. Wooldridge LUTCFAAI ADDRESS:PRODUE— " rncrnMFR In s• JORDA-2 INSURER(S) AFFORDING COVERAGE NAIC # INSURED Jordan's Tree INSURER A:Secura Insurance Companies 22543 Moving & Maintenance, Inc 1025 Smithfield Drive INsuRERs: Pinnacol Assurance 41190 - Fort Collins, CO 80524 INSURERC: INSURER D : INSURER E : INSURER F rOVFRAC.FR rFRTIFIrATF NI IMRFR RFVICIr1N NI IMRFR- 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 LTR D UBR POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DD/YYYY LIMITS GENERAL LIABILITY A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE U OCCUR A f Liab X CP003250287-3 CP003250287-3 12/19/2017 12/19/2017 12/19/2018 12/19/2018 EACH OCCURRENCE $ 1,000,00 PREMISES Ea occurrence $ 300,00 MED EXP (Any one person) $ 10,00 PERSONAL 8 ADV INJURY $ 1,000,00 rG0r�LAGGREGATE GENERAL AGGREGATE $ 2,000,00 LIMIT APPLIES PER: X I PRO- LOC PRODUCTS - COMP/OP AGG $ 2,000,00ICY Prof Liab $ 1,000,00 A AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS X A3200288 12/19/2017 12/19/2018 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,00 X BODILY INJURY (Per person) $ 5,0010 X BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ X X $ UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS -MADE 1 EACH OCCURRENCE $ AGGREGATE $ $ DEDUCTIBLE RETENTION $ $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y/❑NN OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes describe under DESCRIPTION OF OPERATIONS below N/A 4040726 03/01/2017 03/01/2018 X I WC STATU- OTH- T RY LIMITS ER E.L. EACH ACCIDENT $ 1,000,00 E.L. DISEASE - EA EMPLOYEE $ 1,000,00 E L DISEASE - POLICY LIMIT $ 1,000,00 A Equipment Floater 34UUNSR3887 12/19/2017 12/19/2018 Leased 250,00 Ded 50 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) The City of Fort Collins, its officers, agents and employees are named as additional insured with regards to general and auto Liability. CERTIFICATE HOLDER CANCELLATION CITY OF SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Fort Collins ACCORDANCE WITH THE POLICY PROVISIONS. Puchasing Dept. PO Box 580 AUTHORIZED REPRESENTATIVE Fort Collins, CO 80522 © 1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009109) The ACORD name and logo are registered marks of ACORD