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HomeMy WebLinkAbout110001 HIGH PLAINS MECHANICAL SERVICES - INSURANCE CERTIFICATE (2)ACOR& CERTIFICATE OF LIABILITY INSURANCE �4_� 4/1/2018 DATE(MMIDDIYYYY) 3/16/2017 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 endorsement(s). PRODUCER Lockton Companies 444 W. 47th Street, Suite 900 Kansas City MO 64112-1906 (816) 960-9000 CONTACT NAME: IJN'- FAX A/C, No, Ext : INC, No): E-MAIL ADDRESS: INSURERS AFFORDING COVERAGE NAIC # INSURER A: Old Republic Insurance Company 24147 INSURED High Plains Mechanical Service, Inc. INSURER B : Great American Insurance Company 16691 1398315 2020 Airway Avenue Fort Collins CO 80524 INSURER C : Zurich American Insurance Company 16535 INSURER D : Steadfast Insurance Com an 26387 INSURER E : INSURER F COVERAGES CERTIFICATE NUMBER: 13545069 REVISION NUMBER: XXXXXXX 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 INSD SUBR WVD POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DDIYYYY LIMITS A X COMMERCIAL GENERAL LIABILITY Y Y A-7CG-094917- 02 4/1/2017 4/1 /201 8 EACH OCCURRENCE 1,000,000 PREMISES (E. olccur ence 300OOO CLAIMS -MADE OCCUR MED EXP (Any oneperson)1 O OOO PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY PECOT- ❑ LOC P1 PRODUCTS - COMP/OP AGG $ 2,000,000 $ OTHER: A AUTOMOBILE LIABILITY Y Y A-7CA-094917-02 4/1/2017 4/l/2018 Ee COMBINEDaccidenSINGLELIMIT $ 2 OOO OOO X BODILY INJURY (Per person) $ XXXXXXX ANY AUTO OWNED AUTOS ONLY AUTOS BODILY BODILY INJURY (Per accident $ XXXXXXX PROPERTY DAMAGE Per accident $ XXXXXXX HIRED NON -OWNED AUTOS ONLY AUTOS ONLY $XXXXXXX B X UMBRELLA LIAB X OCCUR N N TUU0189267- 07 4/1/2017 4/l/2018 EACH OCCURRENCE $ 5,000,000 AGGREGATE $ 5,000,000 EXCESS LIAB CLAIMS -MADE DED RETENTION $ $ XXXXXXX A AND EMPLOYERS' LIABILI Y YIN ANY ARTNERIEXECUTIVE 1 OFFICERIMEMBER EXCLUDED? (Mandatory in NH) N / A Y A-7CW-094917- 02 4/1/2017 4/l/2018 X STATUTE DER E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE Is 1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below F.L. DISEASE- POLICY LIMIT 1,000,000 D C POLLUTION LIAB INSTALLATION FLTR N N EOC 5833423 - 05 CPP 4886518- 07 4/1/2017 4/1/2017 4/1/2018 4/1 /2018 POLL - OCC/AGG 2,000,000 INSTIL - LIMIT 2,500,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) CITY OF FORT COLLINS IS AN ADDITIONAL INSURED WITH RESPECT TO THE GENERAL AND AUTO LIABILITY COVERAGE, WHICH IS PRIMARY COVERAGE TO THE ADDITIONAL INSURED AND OTHER AVAILABLE INSURANCE WILL BE NON-CONTRIBUTORY AS REQUIRED BY CONTRACT. SUBROGATION RIGHTS ARE WAIVED IN FAVOR OF THE CERTIFICATE HOLDER AS REQUIRED BY CONTRACT AND WHERE ALLOWED BY LAW. CERTIFICATE HOLDER CANCELLATION 13545069 CITY OF FORT COLLINS 215 N MASON ST PO 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 ACORD 25 12016/031 ©19$8-2015 ACORD CORPORATION. All riahts reserved The ACORD name and logo are registered marks of ACORD