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L & L ACOUSTICAL INC - INSURANCE CERTIFICATE 2023-2024
CERTIFICATE HOLDER © 1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) AUTHORIZED REPRESENTATIVE CANCELLATION DATE (MM/DD/YYYY)CERTIFICATE OF LIABILITY INSURANCE LOCJECTPRO-POLICY GEN'L AGGREGATE LIMIT APPLIES PER: OCCURCLAIMS-MADE COMMERCIAL GENERAL LIABILITY GENERAL LIABILITY PREMISES (Ea occurrence)$DAMAGE TO RENTED EACH OCCURRENCE $ MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ PRODUCTS - COMP/OP AGG $ $RETENTIONDED CLAIMS-MADE OCCUR $ AGGREGATE $ EACH OCCURRENCE $ UMBRELLA LIAB EXCESS LIAB DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) INSRLTR TYPE OF INSURANCE POLICY NUMBER POLICY EFF(MM/DD/YYYY)POLICY EXP(MM/DD/YYYY)LIMITS WC STATU-TORY LIMITS OTH-ER E.L. EACH ACCIDENT E.L. DISEASE - EA EMPLOYEE E.L. DISEASE - POLICY LIMIT $ $ $ ANY PROPRIETOR/PARTNER/EXECUTIVE If yes, describe under DESCRIPTION OF OPERATIONS below (Mandatory in NH) OFFICER/MEMBER EXCLUDED? WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N AUTOMOBILE LIABILITY ANY AUTO ALL OWNED SCHEDULED HIRED AUTOS NON-OWNEDAUTOSAUTOS AUTOS COMBINED SINGLE LIMIT BODILY INJURY (Per person) BODILY INJURY (Per accident) PROPERTY DAMAGE $ $ $ $ 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 ADDL WVD SUBR N / A $ $ (Ea accident) (Per accident) 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 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). The ACORD name and logo are registered marks of ACORD COVERAGES CERTIFICATE NUMBER:REVISION NUMBER: INSURED PHONE(A/C, No, Ext): PRODUCER ADDRESS:E-MAIL FAX(A/C, No): CONTACTNAME: NAIC # INSURER A : INSURER B : INSURER C : INSURER D : INSURER E : INSURER F : INSURER(S) AFFORDING COVERAGE SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Network Insurance Services,LLC 7076 S Alton Way Bldg G-1 Centennial CO 80112 303-805-5000 303-708-0202 Certificates@thinkNIS.com NATIONAL AMERICAN INS CO 23663 Pinnacol Assurance of CO 41190L&L Acoustical,Inc. PO Box 2308 Fort Collins CO 80522 2011376243 A X 1,000,000 100,000 X 1,000,000 2,000,000 2,000,000 MP22240405 3/22/2023 3/22/2024 X Y Y 5,000 A 1,000,000 X MP22240405 3/22/2023YY 3/22/2024 A X 1,000,000 1,000,000 MB54650405 3/22/2023 3/22/2024YY B N Y 4214312 1/1/2023 1/1/2024 1,000,000 1,000,000 1,000,000 A Misc Tools 5/19/2023 PR19840405 3/22/2023 3/22/2024 $10,000 Limit $500 Deductible City of Fort Collins PO Box 580 Fort Collins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Lowry Blvd. Denver, CO 80230-7006 303.361.4000 / 800.873.7242 Pinnacol.com L & L Acoustical Inc L & L Insulation LLC P.O. Box 2308 Fort Collins, CO 80522 Network Insurance Services, LLC- P O Box 910 Castle Rock, CO 80104 (303) 708-9999 7501 E. Lowry Blvd Denver, CO 80230-7006 Page 1 of 1 P MINORF - Underwriter 12/16/2022 14:03:02 4214312 80821170 359-B NCCI #: WC000313B Policy #: 4214312 ENDORSEMENT:Blanket Waiver of Subrogation Effective Date:January 1, 2023 Expires on: January 1, 2024 Pinnacol Assurance has issued this endorsement December 16, 2022 We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us. This agreement shall not operate directly or indirectly to benefit anyone not named in the Schedule. SCHEDULE To any person or organization when agreed to under a written contract or agreement, as defined above and with the insured, which is in effect and executed prior to any loss.