HomeMy WebLinkAboutH20 PLUMBING & HEATING INC - INSURANCE CERTIFICATE (2)�� 0 DATE (MM/DD/YYYY)
A
C CERTIFICATE OF LIABILITY INSURANCE 5/1/2017
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 have ADDITIONAL INSURED provisions or 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 endorsements .
PRODUCER CONTNAME: Scott Anderson, CIC ___ _
Commercial Risk Solutions PHONE-- Ft). 303-996-7833 FAX 303-757-7719
6600E Hampden Ave Ste 200 (AIE-MAIL sanderson@crsdenver.com
Denver CO 80224 DRESS:
INSURERS AFFORDING COVERAGE NAIC B
INSURERA:The Phoenix Insurance Co. 25623
INSURED H2OPL-1 INSURERB:TravelerS Prop Casualty of AM 25674
H2O Plumbing & Heating, Inc. INSURERC:Travelers Casualty Ins Co of 19046
15552 E. Fremont Dr. A-104
Centennial CO 80112-6908 INSURER D :
INSURER E:
INSURER F
ftf1VFRArAFC r`FUTICIr"A r= A11111AQ111 oc1nclnu ul uanco.
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
ADDLSUEIR
INSD
WVD
POLICY NUMBER
POLICY EFF
MM/DOlYYYY
POLICY EXP
MM/DD/YYYY
LIMITS
A
X
COMMERCIAL GENERAL LIABILITY
CO-4J336423
5/1/2017
5/1/2018
EACH OCCURRENCE
$1,000,000
CLAIMS -MADE X� OCCUR
DAMAGE TO RENTED
PREMISES Ea occurrence
$300,000
MED EXP (Any one person)
$10,000
PERSONAL & ADV INJURY
$1,000,000
GEN'L
AGGREGATE LIMIT APPLIES PER:
GENERAL AGGREGATE
$2,000,000
RPOLICY
� JEC LOC
PRODUCTS - COMPIOP AGG
$2,000,000
Limited Pollution
$Included
OTHER:
B
AUTOMOBILE
LIABILITY
BA-4J319402
5/1/2017
5/1/2018
COMBINED IN LE LI I
Ea accident
$ 1,000,000
X
BODILY INJURY (Per person)
$
ANY AUTO
OWNED SCHEDULED
AUTOS ONLY AUTOS
BODILY INJURY (Per accident)
)
$
HIRED NON -OWNED
AUTOS ONLY X AUTOS ONLY
X
PROPERTY DAMAGE
Per accident
$
_
A
X
UMBRELLA LIAB
X
OCCUR
CUP-4J375713
5/1/2017
5/1/2018
EACH OCCURRENCE
$2,000,000
AGGREGATE
$2,000,000
EXCESS LIAB
CLAIMS -MADE
DED X RETENTION$None
$
C
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY Y / N
ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICER/MEMBER EXCLUDED? ❑N
N / A
UB-4J339911
5/1/2017
5l1/2018
X I PER OTH-
STATUTE I I ER
E L. EACH ACCIDENT
$1,000,000
E.L. DISEASE - EA EMPLOYEE,$1,000,000
(Mandatory in NH)
If yes, describe under
E.L DISEASE POLICY LIMIT
i $1,000,000
DESCR!PT!ON OF OPERATIONS bciow
A
Inland Marine
CO-4J336423
5/1/2017
5/1/2018
Rntd/Lsd Equip. 70,000
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
All policy terms, conditions and exclusions apply.
City of Fort Collins
300 LaPorte Avenue
Fort Collins CO 80521
G L L/Y I I V IY
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
G 1yt5t3-2U 15 ACORD CORPORATION. All rights reserved.
ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD