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Home My WebLink About102715 HAHN PLUMBING & HEATING INC - INSURANCE CERTIFICATE (2)AFRO® CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 07/25/2017 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 FEDERATED MUTUAL INSURANCE COMPANY HOME OFFICE: P.O. BOX 328 CONTACT NAME: CLIENT CONTACT CENTER A/OCNNo, Ext : 888-333-4949 FAX c No): 507-446-4664 ADDRESS: CLIENTCONTACTCENTER FEDINS.COM OWATONNA, MN 55060 INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: FEDERATED MUTUAL INSURANCE COMPANY 13935 INSURED 314-001-9 INSURER B: FEDERATED SERVICE INSURANCE COMPANY 28304 HAHN PLUMBING & HEATING INC INSURER C: PO BOX 1924 FORT COLLINS, CO 80522-1924 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 21 REVISION NUMBER: 0 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 INSR SUBR WVD POLICY NUMBER POLICY EFF MMIDO/YYYY POLICY EXP MMIDD/YYYY LIMITS A COMMERCIAL GENERAL LIABILITY __1CLAIMS-MADE K OCCUR BUSINESS OWNER'S LIABILITY Y N 9430480 08/31/2017 08/31/2018 EACH OCCURRENCE $1,000,000 DA AGE TO PREMISES t a oct uEroence $100,000 X MED EXP (Any one person) $5,000 GEN'L X PERSONAL & ADV INJURY $1,000,000 AGGREGATE LIMIT APPLIES PER: POLICY ❑PRO ❑ LOC JECT OTHER: GENERAL AGGREGATE $2,000,000 PRODUCTS -COMP/OP AGG $2,000,000 B AUTOMOBILE X LIABILITY ANY AUTO OWNED AUTOS ONLY SCHEDULED autos NON -OWNED HIRED AUTOS ONLY AUTOS ONLY N N 9430481 08/31l2017 08/31/2018 COMBINED SINGLE LIMIT Ea accident $1,000,000 BODILY INJURY (Per person) BODILY INJURY (Per accident) PROPERTY DAMAGE Per acci den A X UMBRELLA LIAB EXCESS LIAR X OCCUR CLAIMS -MADE N N 9430482 08/31/2017 08/31/2018 EACH OCCURRENCE $1,000,000 AGGREGATE $1,000,000 DED RETENTION WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N / A PER STATUTE OTH- ER E.L. EACH ACCIDENT E.L. DISEASE - EA EMPLOYEE E.L DISEASE - POLICY LIMIT DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) CITY OF FORT COLLINS IS NAMED AS ADDITIONAL INSURED ON THE BUSINESSOWNERS LIABILITY POLICY. CFRTIFICATF HOLDFR CANCELLATION 314-001-9 21 0 CITY OF FORT COLLINS UTILITIES DEPARTMENT SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE PO BOX 580 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN FORT COLLINS, CO 80522-0580 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE O 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD Additional Insured Copy FEDERATED INSURANCE COMPANIES THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - STATE OR GOVERNMENTAL AGENCY OR SUBDIVISION OR POLITICAL SUBDIVISION - PERMITS OR AUTHORIZATIONS This endorsement modifies insurance provided under the following: BUSINESSOWNERS LIABILITY COVERAGE FORM SCHEDULE State Or Governmental Agency or Subdivision or Political Subdivision: CITY OF FORT COLLINS P O BOX 580 FORT COLLINS CO 80522 The following is added to Paragraph C. Who Is An Insured: 4. Any state or governmental agency or subdivision or political subdivision shown in the Schedule is also an insured, subject to the following provisions: a. This insurance applies only with respect to operations performed by you or on your behalf for which the state or governmental agency or subdivision or political subdivision has issued a permit or authorization. Insured: HAHN PLUMBING & HEATING INC PO BOX 1924 FORT COLLINS CO 80522 b. This insurance does not apply to: (1) 'Bodily injury", "property damage", or "personal and advertising injury" arising out of operations performed for the state or municipality; or (2) 'Bodily injury" or "property damage" included within the "products -completed operations hazard". Place of Issue: FEDERATED MUTUAL INSURANCE COMPANY Home Office 121 East Park Square Owatonna, MN 55060 (507) 455-5200 Includes copyrighted material of Insurance Services Office, Inc., with its permission. BP-F-254 (08-11) Policy Number: 9430480 Transaction Effective Date: 08-31-2017 Additional Insured Copy FEDERATED INSURANCE COMPANIES THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - STATE OR GOVERNMENTAL AGENCY OR SUBDIVISION OR POLITICAL SUBDIVISION - PERMITS OR AUTHORIZATIONS This endorsement modifies insurance provided under the following: BUSINESSOWNERS LIABILITY COVERAGE FORM SCHEDULE State Or Governmental Agency or Subdivision or Political Subdivision: CITY OF FORT COLLINS UTILITIES DEPARTMENT PO BOX 580 FORT COLLINS CO 80522 The following is added to Paragraph C. Who Is An Insured: 4. Any state or governmental agency or subdivision or political subdivision shown in the Schedule is also an insured, subject to the following provisions: a. This insurance applies only with respect to operations performed by you or on your behalf for which the state or governmental agency or subdivision or political subdivision has issued a permit or authorization. Insured: HAHN PLUMBING & HEATING INC PO BOX 1924 FORT COLLINS CO 80522 b. This insurance does not apply to: (1) 'Bodily injury", "property damage", or "personal and advertising injury" arising out of operations performed for the state or municipality; or (2) 'Bodily injury" or "property damage" included within the "products -completed operations hazard". Place of Issue: FEDERATED MUTUAL INSURANCE COMPANY Home Office 121 East Park Square Owatonna, MN 55060 (507) 455-5200 Includes copyrighted material of Insurance Services Office, Inc., with its permission. BP-F-254 (08-11) Policy Number: 9430480 Transaction Effective Date: 08-31-2017