HomeMy WebLinkAboutMASTER PLUMBING SOLUTIONS LLC - INSURANCE CERTIFICATEACORO� DATE �MMlDDlYYYY)
`,� CERTlFICATE OF LIABILITY INSURANCE z,, Zo24
THIS CERTIFICATE IS fSSUEU AS A MATTER OF INFORMATION ONLY AND CONPERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY pR NEGATiVELY ANlEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE PpLICIES
BELOW. 7HIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTAiIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: !f the certificate holder is an ADDITIONAL INSURED, the policy{kes) must have ADDITIONAL INSURED provisions or be endorsed.
If SUBROGATION IS WAIVED, subjecE 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 certiflcate holder in lieu of such endorsement(s►.
PRODUGER NAME: EIlI18 FiCSql12Z
Madison Insurance Group ,uc r�o ex� :(303) 322-4800 ,qrc, No :(303} 322-0874
7600 E Eastman Ave Ste 500 aopRES5� efresquez@madisoninsurance net
Denver
IMSURED
M�cter Plumbing Solutions Llc
260 Hillspirc Dr
INSURER�S) AFFORDING COYERAGE
CO 8023 I iMSURER A: OWNERS INS CO
iNSUReR e: STATE AUTOMOBILE hfU7' �iJS CO
INSURER C: AUTU OWNERS IIVS CO
iNSURER o: STATE A[iT0 PROP & CAS INS CO
INSURER E :
WindSor CO 80550-6300 INSURER F:
COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE PQLICY PERIOD
INpICATED. NO7IMTHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER pOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAJN, THE lNSURANCE AFFOR�ED 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 GLAIMS.
�7R TYPE OF fNSURANCE iNSO NND POUCY NUMBER MMIDDIYYYYy MMfOD1YYW) LIMITS
X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE S
CLAIMS-MADE a OCCl1R PREMISES (Ea ocarrence) S
X Blkt Additional [nsured MED EXP (Any one person) 3
A X Rlkt Waiver of 3ubrogation Y 74233614 08/06l2023 08/06/2024 pEftSONAL B ADV INJURY S
GEN'L AGGREGA7E LIMIT APPLIES PER: GENERAL AGGREGA7E S
POLICY v PRO-
/► JECT LOC PRODUCTS-COMPlOPAGG E
OTHER: s
AUTOMOBILE LIABIIJTY y
Ea accidenl
X ANY AUTO BODILV INJURY (Per persan) 3
� OWNED SCHEDULED 10058A 18CA 02/OH 2O24 O21OHi2O25 BODILY INJURY (Per xcidenl) E
AUTOS ONLY AUTOS
X AUTOS ONLY X AUT S ONL�Y (Per accdenq
a
x � x ��k, Wos �
�
X UMBRELLA LIAB X OCCUR
C EXCESS UAB CLAIMS�AAADE
DED X RETENTION 3 1 O.U00
Np EMPLOYERS' UABILITY Y! N
NY PROPRIETOR/PARTNER/EXECUTIVE N !A
D FFICER/MEMBER EXCLUD£D? �
Mandatory in NH)
H yes, desaibe under
ESCRIPTION OF OPERATIONS below
EACH OCCURRENCE E
08/06 2023 08106i2024 AGGREGATE E
E
X STATUTE ER
02/08 2024 02l08+'2025 E L EACH ACCIDeNT 3
E L DISEASE - EA EMPLOYEE E
E L DISEASE - POLICY LIM.T E
4956642901
10196931 WC
DESCRIPTION OF OPERAT1pNS ! LOCATIONS ! YEHICLES (ACORD 101, Additlonal Remarks Schedule, may be attached N more apace is requlred)
RE: Contractor's Liccnse. City of Fort Collins is additional insured as regards work performed by the insurcd.
NAfC �
32700
25135
18988
25127
i,000,000
300,OQ0
i o,oao
I ,OOO,OQD
z,000,000
2,000,000
I ,000,000
i ,00a,000
I ,OOQ,000
i .00a,000
I ,000,000
I ,000,000
City of Fort Collins
Bui2ding Services
281 N. College Ave.
Fort Collins CO 80524
ACORD 25 (2016103)
SNOULD ANY OF THE ABOVE DESCRIBEO POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANGE WITH THE POLICY PROVISIONS.
Il?fORFZEU REPRESENTATIVE
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