HomeMy WebLinkAboutJ&M BUILDERS, LLC - INSURANCE CERTIFICATEACORO� DATE (MMIDWYYYY)
`„r� CERTIFICATE OF LIABILITY INSURANCE 4„�Zoz3
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RiGHTS UPON THE CER7IFICATE HOLDER. THIS
CERTIFICATE DOES NQT AFFIRMATIYEI.Y OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTftACT BETWEEN THE ISSUING INSURER{S), AUTHORIZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: Ii the certFficate holder !s an ADDITIOMAL INSURED, the pollcy(les) must have AODITIONAL INSURED provislons or be endorsed.
If SUBROGATIOM IS WAIVED, subject to the tertns and conditions of the policy, certa3n policies may require an endorsement. A statement on
this certi(icate does not confer rights to the certiflcate holder in Ileu of such endorsement(s).
PROOUCER Karole Peters
NAME:
Madison Insurance GrouP arC No ert :�303) 322-0800 AIC, No :(303) 322-0874
7600 E Eas�man Ave Ste 506 ADDRESS� kpetersidmadisoninsurance.nel
Denver
INSURED
1&M Bwldcrs, LLC
5045 PRAIRIE LARK LN
SEVERAIYCE
CO 80231
CO 80615-8106
NAIC A
IS$72
I HIS IS I U GERTIFY THAT �HE POLICIES UF INSURANCE LISTED BELUW HAVE BEEN ISSUED TO THE INSUftEO NAMED A6UVE FUR THE POUCY PERIOD
INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR COMDITION OF ANY CONTRACT OR OTHER DOCUMEN' 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 tIMITS SHOWN MAY HAVE BEEN REDUCED BY PA D CLAlMS.
7ry TYPE OF INSURAMCE IHSD NND POUCY NUMBER MMlD MMl� LIMITS
X COMMERCIALGENERAL LIABILITY EACH OCCURRENCE 5
CLAIMS�JAAOE � OCCUR PREMISES (Ea occurrenceJ S
x Blanket Additional [nsured MED EXP (My one person) S
A x Blankct Warvcr of Subrogauon CMV-P1,4003 '921-01 04i01 20?3 G4J012024 pERSONAL & AOV NJURY S
GEN'L AGGREGATE LIMIT APPI ES PER GENERAL AGGREGATE S
POLICY � �E a � LOC PRODUCTS COMPlOP AGG b
pTHER S
AUTOMOBtLE LIABILITY �E� ���) 5
ANY AUTO BODILY INJURY (Per person) 5
OWNEO SCHEDULED Not Insured w�th Madison BODfLY INJURY (Per aaidenl) 5
AUTOS ONLY AUTOS
HIREO NON�OWNED �
AUTOS ONLY AUTQS ONLV (Per aaidenl?
S
UMBRELLALtAB p�CUR EACH OCCURRENCE S
EXCESS UAB CLAIMS•MADE Not Insured w�th Madison AGGREGATE u S
DED RETENTION S S
EMPLOYERS' L1ABlLITY Y! N
PROPRIETOfL'PAhcfNERIEXECUTIVE E.L.EACHACCIDENT b
"ER/MEMB£R EXC�UDEO? � N 1A Nol Insured wEth Madison
datory In NH� E.L. DISEASE - EA EMPLOYEE S
, OesrtiCevnOer
;RIPTION OF OPERATIONS Celow E.L. DISEASE - POUCY LIMIT S
DESCRIPTION OF OPERAT10N51 LOCA710NS 1 VEHIClES �ACORQ 101, AdEfGonsl RemeAcs Schedule, may be ethched H more spece is requlred)
License
CERTIFlCATE HpLDER
City of Fort Coilins
281 N. College
� Fort Collins CO 80524
ACORD 25 (201fi/03}
1,00O,OOQ
30QOOQ
Excluded
1,UOU,OQO
2,000,00(1
2,QOU,UO(1
INSURER(S) AFFORDIHG COVERAGE
iNsuReR n: CM VANTAGE SPEC[ALTY Rv'S CO
INSURER B :
INSURER C :
INSURER D .
INSURER E :
INSURER F :
SHOULD 0.NY OF THE ABOVE DESCRIBEO POLICIES BE CANCELLED BEFORE
THE EXPIRATION DA7E THEREOF, NOTICE YYILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
AUTH6RI2ED REPRESENTATIVE
K�raf� Pcttrs
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