HomeMy WebLinkAboutSHAMES CONSTRUCTION COMPANY, LTD. - INSURANCE CERTIFICATE�� DATE (MM�DD/YYYY)
A�RO� CERTIFICATE OF LIABILITY INSURANCE
1/412024
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CHRTtFiCATE HOLDER. TH15
CERTIFICA7E DOES NOT AFFIRMATIVEI.Y OR NEGA7IVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDEb BY tHE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUiNG iNSURER(S), AIiTHORIZED
AEPRESENTATIVE OFI PRpDUCER, AND 7HE CERTIFICATE HOLDER.
IMPORTANT: If the certificete halder Is an ADDITIONAL INSURED, the pol[cy(les) must have ADDITIONAL INSURED provisions or be endorsed.
If SU8ROGATION IS WAiYEO, subject to the terms and conditfons of the polkcy, certain policles may requfre an endorsement. A slatement on
this certtticate dqes nat confer N hts to the tertEficate holder In lieu of such endorsement s.
PRODUCER MAME: C IMA Denver Team
IMA, Inc. - Colorado Division pHo"E . 303-534-4567 �� ac No:
1705 17th Street, Suite 1 QO -MAi�
Denver CO 8Q202 nooREss: DenAccountTechs(pAimacorp.com
IldSURERiSlAFFORDIkG COVERAGE NAIC q
iNSurtErt A: Hartford Fire Insurance Com an 19682
INSURED SHAMCON �NsuaeR e: Hartford Accident and indemnity Compan 22357
Shames Construction Company, Ltd. iNsuAeRc: Hartford Casualty Insurance Comp��� 29424
5826 Brisa Street, Suite E
Livermore CA 94550 INSURERD:
INSURER E :
INSUpER F :
COVERAGES CERTIFICATE NUMBER: 1765187042 REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF IIVSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOO
tNDICATED. NOTWITHSTANDING ANY REQUlREMENT, TERM pR CONOITIOiJ OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTiFICATF MAY BF 1SSUED OR MAY PERTAfN, 7HE INSURANCE AFFORDED BY THE POl1CIES DESCRIBED HEREIN IS SUBJFCT TO ALL THE T£RMS.
EXCLUSIONS AND CONDITIONS OF 5UCH POLICIES. LIMf�lS SHOWN MAY FiAVE BEEN REOUCED BY PAID CLAIMS.
iNSR 7ypEOFINSURANCE AOOI tJ'BAi � POLIp YEFF^ �P�LICYEXP ����
LTR IN D WV POUCYNUMBER MLU'D6/YYYY I Mllt'D0.'VYY
A X CQMMERCIALGENERALLIABILRV 34UEAAC9582 1/112024 1J112025 FACHOGCURRENCE SZ.00O,QUO
DPiM.ti(�`i�T�lRENTED �
CLAIMS�MADE , x OCCUR PFIEMISES Ea ocwrrence S 3qQ,4Q0
__.1____���—
� PO Dad S5 000 MED E%P (Any one pergon� $ 10,OQ0
PERSONAL 8 ADV IN,fURY j2,0OD.00U
GEN'L AGGHEGATE LIMI7' APPLIES PEH GENERAL AGGREGATE 54,009,000
POLlCY u JECT �_I ��� PRODUCTS • CdMP�OP AGG 54 000,004
OTHER =
6 AUTOM081LEUASIL7TY { 34 UEA AC8561 1/112024 1/1/2025 C(JMBINEO SINGLE UMIT § � QD0,040 �
� �Ea acddem)
X ANY AUiO 80DILY INJURY ;Per person: S
OWNED SCHEOULED 9pDILYINJURY PCraoGdenf� S ���
AUTOS ONLY AUTOS
X HIRED x NOM OWNED PROPERTY DAh4AGE $
AUTOS ONLY AVTp50NLY Per accident , ,
b
C X UMBRELLA ItAB X pCCUR 34 RHA AC8910 11112024 1/1l2025 i EACH (7CCURRENCE 5 l0 000,DD0
EXCESS L1AB CLAiA6S-MMQE AGGFEGATE � 10 000 000
DEO Y` REfENTIONb S
C WOFiKERSCa.[PENSanON 34 VuEA BBSS46 111/2024 1f1/2025 X PE� ��•
AND EMPLOYERS' LIAB�LfTY Y� N _ STATUTE ER
ANYPROPRiETOW�PARTNERIEXECUFIVE a E I. EACH ACCIOENT a 1,4Q0,000
OFFICER�lAEMBEREXCLUOED? N! A
(Mendetory In NH) E L. DISEASE EA EMPLOYEE � 1 000.000
If yes, describa under `�'--
DESCRIPTIO�v OF OPERAiIONS bebw E l. OISFI�SE AOUCY LIM17 S 1.Q00,000
VYC-IIYps
Cha+rman f
Pres+denVCEO �
I
DESCRIPTION OF OPERATIONS! LOCATIONS � YEHtCLE5 (ACORD 101, Additlanal fiemarke Schedule, mey be attached It more apece Ia raqu0ad)
ProPerty Coverage: Policy #UM00072532MA24A
Effective Dates: 01/01124-01l41/25 Insurer XL 5pecfalty Insurance Gompany
$250,000 Leased B� Rented Equipment Limit, $S,OOd Deducdble
$777,500 Personal Property Limit; $5,000 DeducUble SPC FormlRC
See Attached...
ER
SH013L0 ANY OF THE ABOVE OESCRIB£D POUCIES BE GANGELLED BEFOFiE
THE EXPlRATION DATE THEREOF, NOTICE WILt BE DELIVERED IN
ACCORUANCE WITH FHE POUCY PROVISIONS.
City of Fvrt Collins
281 N. College Ave.
Ft. con��,s ca ea�24
ACORQ 25 {2016/03)
AUTHORIZEU REPRESfNTAT1VE
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01988-2015 ACORD CORP4RATION. All rights reserved.
The ACORD name and logo are regfstered marks of ACORD
2561 J ' of
AGENCY CUSTOMER ID_ SHAMCON
LOC ft:
ACC.1R0�
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AQENCY
IMA, Inc, - Colorado Division
POLICV NUMBER
CARRIER
ADDITIONAL REMARKS SCHEDULE
NAIC CODE
NAMED INSUFiEO
Shames Construction Company, Ltd
5826 Brisa Street, Suite E
Livermore CA 94550
EFFECTIVE bA7E:
Page 1 of 1
2561: 3 ' af
AC4RD 101 (2008l01) � 2008 ACORD CORPORATION. Ail rights reserved.
The ACORD name and logo are reglstered marks of ACORD