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HomeMy WebLinkAboutJANSMA BROS EXCAVATING & TRUCKING CORP - INSURANCE CERTIFICATE (7)JANSBRO-01 LPREW ACORO CERTIFICATE OF LIABILITY INSURANCE FDATE(MM/DD/YYYY) O5/0812017 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 PFS Insurance Group 4848 Thompson Parkway Suite 200 Johnstown, CO 80534 INSURED Jansma Bros. Excavating & Trucking Corp. 1475 Backhoe Road Loveland, CO 80537 INSURER D : INSURER E : INSURER F : 635-9400 rnVFRAr,FS CFRTIFICATF NIIMRFR• RFVICInKl NI IMRFR- 635-9401 21415 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 AD DL SUBR� POLICY NUMBER POLICY EFF POLICY EXP LIMITS TR M/DD/YYYY MM/DD/YY A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE X OCCUR _ GENT AGGREGATE LIMIT APPLIES PER POLICY X JEC LOC OTHER: PKGO19028302 04/01/2017 04/01/2018 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED PREMISE$. (Ep-occurrencel ME EXP (Any one arson PERSONAL & ADV INJURY 100,000 $ 61000 1,000,000 GENERAL AGGREGATE $ 2,000,000 PRODUCTS-COMP70PAGG $ 2,000,000 B AUTOMOBILE LIABILITY X ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS X HIRED X NON0WNED AUTOS ONLY AUTOS ONLY I4E90700 04/01/2017 04/01/2018 COMBINED SINGLE LIMIT _(Ea accident)_ BODILY INJURY Per arson BODILY INJURY Per accident 1,000,000 $ $ PROPERTY AMAGE Per accident $ A X UMBRELLA LIAB X OCCUR EXCESS LIAB CLAIMS -MADE DIED X RETENTION $ 10,000 IUMB019028402 04/01/2017 04/01/2018 EACH OCCURRENCE $ 11000,000 AGGREGATE $ 1,000,000 C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y / N 2342390 OFFICER/MEMBER EXCLUDED? N / A (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below 0W01/2017 OW0112018 PER X STATUTE OTH E.L. EACH ACCIDENT 100,000 E.L. DISEASE - EA EMPLOYEE $ 100,000 50D,DDD E.L. DISEASE - POLICY LMAR DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) ALL OPERATIONS - ALL LOCATIONS. l.tK 1 IVIL A I t NULUtK L:ANL:tLLA I IUN City of Fort Collins 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 ACORD 25 (2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD