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HomeMy WebLinkAbout501238 GREENING UP LANDSCAPE MAINTENANCE INC - INSURANCE CERTIFICATE (3)GREEN-U OP ID: JD F.IDDrACORO" CERTIFICATE OF LIABILITY INSURANCE DATE (M1/20 7 05/3/2017 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 CONTACT Brown & Brown Inc NAME: Jody Wagner 4532 Boardwalk Dr, Suite 200 PHONE o Ext :970-482-7747 FAX No): 970-484-4165 _ Fort Collins, 80525 ADDRE William S. Richh SS: jwagner@bbcolorado.com INSURER(S) AFFORDING COVERAGE NAIL # INSURER A : Westfield Insurance Company 24112 INSURED Greening Up Landscape INSURER B : Pinnacol Assurance Company 41190 Maintenance, Inc. 1942 E Lincoln Ave, Unit B INSURERC: Fort Collins, CO 80524 INSURER D : INSURER E : INSURER F : :.O`JrRAC—,FS CFRTIFICGTF NIIMRFR• RFVICIf1N N1IMR9=17• 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 L POLICY EFF POLICY EXP LTR POLICY NUMBER MM/DD/YYYY MM/DD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE )(I OCCUR X X CWP6058374 06/01/2017 06/01/2018 PREMISES Ea occurrence) $ 300,00 MED EXP (Any one person) $ 5,00 PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER POLICY Fj(1 PE O El LOC GENERAL AGGREGATE $ 2,000,00 PRODUCTS - COMP/OP AGG $ 2,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ 1,000,000 A X ANY AUTO X X CWP6058374 06/01/2017 06/01/2018 BODILY INJURY (Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ NON -OWNED HIRED AUTOS AUTOS q PROPERTY DAMAGE Per accident $ $ X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 3,000,000 A EXCESS LIAB CLAIMS -MADE CWP6058374 06/01/2017 06/01/2018 AGGREGATE $ 3,000,000 DED X RETENTION $ 0 $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE YIN OFFICER/MEMBER EXCLUDED? ❑NIA (Mandatory in NH) If yes, describe under DESCRF-71ON OF OPERATIONS beiu X 199093 02110/2017 02101/2018 X PER 0 H- STATUTE ER $ 500,000 - - $ 500,000 $ 500,000 E.L. EACH ACCIDENT E.L. DISEASE - EA EMPLOYEE E.L. D SEASE - POLICY MIT LIMIT A Leased/Rented Equi CWP6058374 06/01/2017 06/01/2018 Lsd/Rntd 25,000 Ded 500 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) City of Fort Collins is included as Additional Insured as respects to General Liabliity and Automobile Liability per conditions and forms shown on page 2. Fax#970-221-6707 VCR I Iri%,m IC r1VLUCR CITYFII City of Fort Collins P O Box 5080 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 Y4, © 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD GREEN-U NOTEPAD INSURED'S NAME Greening Up Landscape OP ID: JD If Required By Written Contract: 7ommercial General Liability: Blanket additional insured applies for ongoing and completed 3perations CG2033 & CG7133 ?rimary, non-contributory basis CG 2001 Blanket waiver of subrogation CG7094 7ommercial Auto Liability: Blanket Additional Insured and Naiver of subrogation CA7068. corkers Compensation: Blanket waiver of subrogation applies per form 359-B. la follows form. PAGE 2 Date 05/31/2017