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HomeMy WebLinkAbout120528 FORT COLLINS TREE CARE - INSURANCE CERTIFICATE (9)FORTCOL-09 CWATSON A�ORD CERTIFICATE OF LIABILITY INSURANCE DATE316/2/6/2DIYYYY) 017 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 CONTACT NAME: Angela Gross TrueNorth Companies, LC PHONE VAX - 275 South Main Street, Suite 100 (AIC, (Aic,Nol: Longmont, CO 80501 AADDREss: agrosstMtruenorthcomaanles.com INSURED Fort Collins Tree Care, Inc 301 East Douglas Road Fort Collins, CO 80524 INSURERS) AFFORDING COVERAGE INSURERA:Twin City Fire Insurance Comp INsuRER e : Pinnacol Assurance ComDanv D: E: F: COVERAGFS CFRTIFIi-ATF nii iRfiRF►e• 03 %AcinKi Rii ii+A000- NAIL • 190 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 - - ADDL SR - POLICY EXP LTR TYPEOFINSURANCE INSD WVDUBi POLICY NUMBER MMIDDIWYY) (MM/DD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY IEACH OCCURRENCE $ 1,000,00 CLAIMS -MADE X OCCUR X �34UUNSR3900 i 03/05/2017 03/06/2018 PREAGETORENTED— MISES (Ea occurrence)$ 300,00 X LTD POLLUTION LIAB W MED EXP (Any one person) $ 10,000 X PESTICIDE/HERBICIDE* PERSONAL & ADV INJURY $ 1,000,00 $ 21000,00 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY X JECT LOC GENERAL AGGREGATE PRODUCTS -COMP/OPAGG $ 2,000,0011 OTHER: *LTD POLLUTION s Includec AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea acadent $ 1,000,00 A X ANY AUTO 34UUNSR3900 03/05/2017 03/06/2018 BODILY INJURY (Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ X HIRED AUTOS X NON -OWNED __ . AUTOS PROPERTY DAMAGE Per accident S UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS -MADE AGGREGATE $ $ DED RETENTION S B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBEREXCLUDED? ❑ (Mandatory in NH) Ii yes, describe under DESCRIPTION OF OPERATIONS below N/A 4148327 06/01/2016 05/01/2017 PER OTH- X STATUTE ER E.L. EACH ACCIDENT _ E.L. DISEASE - EA EMPLOYEE --- - - — ------ E.L. DISEASE - POLICY LIMIT $ 100,00 - $ 100,00 $ 500,00 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) City of Fort Collins as Additional Insured as required by written contract. CERTIFICATE HOLDER CANCELLATION City of Fort Collins Purchasing Division P O Box 580 Fort Collins, CO 80522 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 I&MA 0140104-1 ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD