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HomeMy WebLinkAboutBRIGHTVIEW LANDSCAPES LLC - INSURANCE CERTIFICATE (5)��1 ® AFRO CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 09/12/2017 I 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 Aon Risk Services Northeast, Inc. New York NY office CONTACT NAME: (A/CNN . Ext): (866) 283-7122 A/C. No.): (800) 363-0105 E-MAIL ADDRESS: 199 water Street New York NY 10038-35S1 USA INSURER(S) AFFORDING COVERAGE NAIC # INSURED INSURER A: ACE American Insurance Company 22667 Brightview Landscapes. LLC INSURER B: American Guarantee & Liability Ins Co 26247 401 Plymouth Road Plymouth Meeting PA 19462 USA INSURER C: INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 570068316321 REVISION NUMBER: 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. Limits shown are as requested INSR LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER MM/DD/YYYY MMlDD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY XSLG EACH OCCURRENCE $1,000,000 CLAIMS -MADE X❑ OCCUR SIR applies per policy terns & conditions AMA N PREMISES Ea occurrence $1,000,000 MED EXP (Any one person) $10 , 000 PERSONAL &ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $4,000,000 POLICY X PRO LOC JECT PRODUCTS - COMP/OP AGG $4,000,000 OTHER A AUTOMOBILE LIABILITY ISA H09088908 10/01/2017 10/01/2018 COMBINED SINGLE LIMIT Ea accident $2 , 000 , 000 BODILY INJURY ( Per person) X ANYAUTO BODILY INJURY (Per accident) OWNED SCHEDULED AUTOS ONLY AUTOS X HIRED AUTOS X NON -OWNED ONLY AUTOS ONLY PROPERTY DAMAGE (Per accident B X UMBRELLA LIAB X OCCUR AUC508596813 10/01/2017 10/01/2018 EACH OCCURRENCE $10,000,000 EXCESS LIAB CLAIMS -MADE AGGREGATE $10 , 000 , 000 DED RETENTION A AOFFICER/MEMBER WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR / PARTNER / EXECUTIVE YIN EXCLUDED? (Mandatory in NH) NIA C48033301 WC - ADS C48033313 WC - wI 10/01/2017 10/01/2017 10/01/2018 10/01/2018 X STA UTE EORH E.L. EACH ACCIDENT $2 , 000 , 000 E.L. DISEASE -EA EMPLOYEE $ 2 , 000 , 000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT $2 , 000 , 000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Re:Old Town Square Irrigation System Project #6084. General Liability per Project General Aggregate applies when required by written contract. The City of Fort Collins and Downtown Development Authority are named as Additional Insureds with regards to General Liability. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. CITY OF FORT COLLINS AUTHORIZED REPRESENTATIVE PURCHASING DIVISION 215 NORTH MASON STREET, 2ND FLOOR FORT COLLINS CO 80524-4402 USA FOR �i. + ' �/f .� c a G "*"a r eJ J ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD ADDITIONAL INSURED — ENGINEERS, ARCHITECTS, OR SURVEYORS Named Insured Endorsement Number BrightView Landscapes, LLC Policy Symbol Policy Number Policy Period Effective Date of Endorsement XSL G28103670 001 10/1 /17 to 10/1 /18 10/01 /2017 Issued By (Name of Insurance Company) ACE American Insurance Company Insert the policy number. The remainder of the information is to be completed only when this endorsement is issued subsequent to the preparation of the policy. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This Endorsement modifies insurance provided under the following: EXCESS COMMERCIAL GENERAL LIABILITY POLICY A. Section II — Who Is An Insured is amended to include as an additional insured any architect, engineer, or surveyor engaged by you but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused. in whole or in part, by your acts or omissions or the acts or omissions of those acting on your behalf: 1. In connection with your premises; or 2. In the performance of your ongoing operations. However: 1. The insurance afforded to such additional insured only applies to the extent permitted by law; and 2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afford- ed to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. B. With respect to the insurance afforded to these additional insureds, the following additional exclusion applies: This insurance does not apply to "bodily injury", "property damage" or "personal and advertising injury" arising out of the rendering of or the failure to render any professional services by or for you, including: 1. The preparing, approving, or failing to prepare or approve, maps, shop drawings, opinions, reports, sur- veys, field orders, change orders or drawings and specifications; or 2. Supervisory, inspection, architectural or engineering activities. This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in the su- pervision, hiring, employment, training or monitoring of others by that insured, if the 'occurrence" which caused the "bodily injury" or "property damage", or the offense which caused the "personal and advertising in- jury", involved the rendering of or the failure to render any professional services by or for you. XS-21184a (04/13) Page 1 of 2 Includes copyrighted material of Insurance Services Office, Inc., with its permission 0 �` �R� CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) o9/1212017 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 Aon Risk Services Northeast, Inc. New York NY Office CONTACT NAME: (Afc. No. Exq: (866) 283-7122 �aC (800) 363-0105 E-MAIL ADDRESS: 199 Water Street New York NY 10038-3551 USA INSURER(S) AFFORDING COVERAGE NAIC # INSURED INSURER A: ACE American Insurance Company 22667 INSURERB: BriQhtVieW Landscapes, LLC 401 Plymouth Road Plymouth Meeting PA 19462 USA INSURER C: INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 570068352639 REVISION NUMBER: 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. Limits shown are as requested INSR LTR TYPE OF INSURANCE ADDL INSD SUER WVD POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY Ex MM/DD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY XSLG . EACH OCCURRENCE $1 , 000 , 000 CLAIMS -MADE X❑ OCCUR SIR applies per policy terns & condi ions A PREMISES Ea occurrence $1,000,000 X Contractual Liability MED EXP (Any one person) $10 , 000 X XCU Hazard PERSONAL & ADV INJURY $1 , 000 , 000 GEN'LAGGREG�ATTE LIMITAPPLIES PER: GENERAL AGGREGATE $4,000,000 POLICY X I PRO LOC I7X JECT PRODUCTS - COMP/OP AGG $4 , 000 , 000 OTHER. A AUTOMOBILE LIABILITY Y ISA H09088908 10/01/2017 10/01/2018 COMBINED SINGLE LIMIT Ea accident $2 , 000, 000 BODILY INJURY ( Per person) X ANY AUTO BODILY INJURY (Per accident) OWNED SCHEDULED AUTOS ONLYEAUTOS HIREOAUTOS NON -OWNED X ONLY AUTOS ONLY PROPERTY DAMAGE Per accident UMBRELLA LIAB EACH OCCURRENCE AGGREGATE EXCESS LIAB HOCCUR CLAIMS -MADE DED RETENTION A A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR I PARTNER / EXECUTIVE YIN OFFICER/MEMBEREXCLUDED9 (Mandatory in NH) N/A C48033301 WC - ADS C48033313 WC - WI 10101120171010112018 10/Ol/2017 10/Ol/2018 X STATUTE EORH E.L. EACH ACCIDENT $2 , 000 , 000 E.L. DISEASE -EA EMPLOYEE $2 , 000, 000 If yes, describe under DESCRIPTION OF OPERATIONS below D E.L. DISEASE -POI. ICY LIMIT $2 , 000 , 000 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) The City of Fort Collins is included as Additional Insured in accordance with the policy provisions of the General Liability and Automobile Liability policies. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. The City Of Fort Collins AUTHORIZED REPRESENTATIVE Purchasing Department PO BOX 580 Fort Collins Co 80500 USA (V �f� rn co Cl) cc 0 1` LO O Z i0+ W U d U ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - COMPLETED OPERATIONS Named Insured Endorsement Number BrightView Landscapes, LLC Policy Symbol Policy Number Policy Period Effective Date of Endorsement XSL G28103670 001 10/01 /17 to 10/01 /18 10/01 /2017 Issued By (Name of Insurance Company) ACE American Insurance Company Insert the policy number. The remainder of the information is to be completed only when this endorsement is issued subsequent to the preparation of the policy. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This Endorsement modifies insurance provided under the following: EXCESS COMMERCIAL GENERAL LIABILITY POLICY SCHEDULE Name Of Additional Insured Person(s) Or Or anization s : Location And Description Of Completed Opera - tions Any person or organization whom you have agreed to All locations where you perform work for such include as an additional insured under a written additional insured pursuant to any such written contract. contract, provided such contract was executed prior to the date of loss. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II — Who Is An Insured is amended to include as an additional insured the person(s) or organiza- tion(s) shown in the Schedule, but only with respect to liability for "bodily injury" or "property damage" caused, in whole or in part, by "your work" at the location designated and described in the Schedule of this endorse- ment performed for that additional insured and included in the "products -completed operations hazard". However: 1. The insurance afforded to such additional insured only applies to the extent permitted by law; and 2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afford- ed to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. B. With respect to the insurance afforded to these additional insureds, the following is added to Section III — Limits Of Insurance And Retained Limit: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement; or 2. Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. 01 Authorized Representative XS-21164a (04/13) Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 1 of 1