HomeMy WebLinkAboutANYTIME MECHANICAL LLC - INSURANCE CERTIFICATE (6)1 ®
A� L7 CERTIFICATE OF LIABILITY INSURANCE
DATE (MMIDDIYYYY)
07/31 /2018
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
Moody Insurance Agency, Inc.
8055 East Tufts Avenue
Suite 1000
Denver CO 80237
NAME: CONTACT Kathy Werner
PHONEo (303} 824-6600 FAx (303) 370-0118
AIC NEzt : AIC No
E-MAIL kathy.werner@moodyins.com
ADDRESS:
_
INSURER(S) AFFORDING COVERAGE
NAIC #
INSURER A : Westfield Insurance Company
24112
INSURED
Anytime Mechanical, LLC
9070 Marshall Ct.
Westminster CO 80031
INSURER B : Plnnacol Assurance
41190
INSURER C :
INSURER D :
INSURER E :
INSURER F :
COVERAGES CERTIFICATE NUMBER: 18-19 w/ Forms 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.
ILTR
TYPE OF INSURANCE
INSD
WVD
POLICY NUMBER
MM DDY/YYYY
MMDD/YYYY
LIMITS
X
COMMERCIAL GENERAL LIABILITY
EACH OCCURRENCE
$ 1,000,000
CLAIMS -MADE � OCCUR
DAMAGE TO RENTED
PREMISES Ea occurrence
$ 500,000
MED EXP (Any one person)
$ 5,000
PERSONAL & ADV INJURY
$ 1,000,000
A
CVVP7844631
08/21/2018
08/21/2019
GEN'L AGGREGATE LIMIT APPLIES PER:
GENERAL AGGREGATE
$ 2,000,000
PRODUCTS - COMP/OPAGG
$ 2,000,000
POLICY a JECT PRO- ❑ LOC
$
OTHER:
AUTOMOBILE LIABILITY
COMBINED SINGLE LIMIT
Ea accident
$ 1,000,000
BODILY INJURY (Per person)
$
X ANY AUTO
BODILY INJURY (Per accident)
$
A
OWNED SCHEDULED
AUTOS ONLY AUTOS
HIRED NON -OWNED
AUTOS ONLY AUTOS ONLY
CWP7844631
08/21/2018
08/21/2019
PROPERTY DAMAGE
Per accident
$
Underinsured motorist
$ Included
X
UMBRELLA LIAB
OCCUR
EACH OCCURRENCE
$ 1,000,000
HCLAIMS-MADE
AGGREGATE
$ 1,000,000
A
EXCESS LAB
CWP7844631
08/21/2018
08/21/2019
DED I X1 RETENTION $ 0
$
B
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY YIN
ANY PROPRIETOR/PARTNER/EXECUTIVE FT]
OFFICER/MEMBER EXCLUDED?
(Mandatory in NH)
NIA
4196007
10/01/2017
10/01/2018
PER OTH-
X STATUTE ER
E.L.EACH ACCIDENT
1,000,000
$
E.L. DISEASE - EA EMPLOYEE
$ 1,000,000
E.L. DISEASE - POLICY LIMIT
$ 1,000,000
If yes, describe under
DESCRIPTION OF OPERATIONS below
Limit
$30,000
A
Leased/Rented Equip
CWP7844631
08/21/2018
08/21I2019
DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space is required)
CERTIFICATE HOLDER cANUhLLAIIVIV____
RECEIVED SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
City of Fort Collins AUG,07 -t O
2O1p ACCORDANCE WITH THE POLICY PROVISIONS.
300 LaPorte Ave.
AUTHORIZED REPRESENTATIVE
Fort Collins City Manager's Uiff$b521 41_u — 0.�
I
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