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Home My WebLink AboutACADEMY ROOFING INC - INSURANCE CERTIFICATEAC o� CERTIFICATE OF LIABILITY INSURANCE �ATE(MM/DOlYYVY) �� oaiz5rzoz3 THIS CER7IFICATE 15 ISSUED AS A MATTER OF INFORMATIdN ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DpES NOT AFFIRMATIVELY OR MEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE UOfS NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certifitate 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 conditlons of the policy, certain policies may require an endorsement. A statement on this certiflcate does not confer rights to the certificate holder In lleu of such endorsement{s). PRODUCER NAME: ��dy InsuranceAgency Moody Insurance Agency, Inc. PH� K Exc :(303) 824-6600 �C No ;(303) 37C 0118 8055 EasS Tufts Avenue Ea"�� cerirequest@moodyins.com AODRE53: SUit@ 1000 INSURER�S� AFFORpiNG GOVERAGE NAIC p Denver CO 80237 iNsuRERA: CincinnalilnsuranceCompany 7067� INSUREO INSURER B : Academy Roofing, Inc. iNSURER C: Uniled Specialty Insurance Co 12537 1610 Jasper Street iHsurteR o: Pinnacol Assurance 4119G Aurora CO 80071-4649 I �NSURER F: COVERAGES CERTIFtCATE NUMBER: 23-24 Master REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED SELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PEftIOD INDICATED. NOTVNTHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE fNSURANCE AFFORDEO BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL TNE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS S}-tOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. �LTR TYPE OF INSURANCE INSD WVD P6LICY NUMBER M�DY� MMlDUYM'VY LIMITS x COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE 5 1 OOO OOO CLAIMS-MAOE �X OCCUR pREMlSES EaoccuRence S 500,000 MED £XP (Any one parsonl S �fl Q00 A EPP0134068 0510112023 05/01/2024 pERSONAL & AOV INJURY 3��000 000 G£k'LAGGREGATELIMITAPPLIESPER� GENERALAGGREGATE S 2.000000 POLiCY ❑X pR0• � 2,000 040 JECT �� PRODUCTS-COMPlOPAGG S O7HER: s AUTOMOBILE LIABILITY COMBINED SINGLE lIM1T S 1,Oi1O OOO Ea acadenl X ANY AUTO BODILY INJURY (Per person) S A OVrNEO SCHEDULED EPP0134068 OSJOlI2023 OSIOil2024 BODILYINJURY�Perattitfent) S AU705 ONLY AUTOS HIRED NON•�WNE� PROPERTY OAMAGE S AUTOS ONLY AUTOS ONLY Per aw6ent S UMBRELLA LIAB pCCUR EACH OCCURRENCE S S,O00,000 C X E7(CESS LIAB CLA MS MADE BTN2340174 OS101/20Z3 0510112024 AGGREGATE S S,OOO,OOO DED %C RETENTION S � 5 WORKERS COMPENSATION PER OTH- AND EMPLOYERS' LfABILITY x STATUTE ER Y 1 N 1 ,000,0�� p ANY PROPRIETOR/PARTNERIEXECUTIV£ a N I A 1231300 10I07I2022 10/O1I2023 E L. EACH ACCIDENT 5 OFFICERIMEMBER EXCLUDED� (Mandatory In NH) E.L DISEASE - EA EMPLOYEE S��000,000 If yes, describe under 1,000,000 ❑ESCRIPTION OF OPERATIONS DOtow E L. DISEASE • PQUCY LIMR S DESCRIPTION OF OPERATIONS J LOCATIONS 1 VEHiCLES {ACORD 101, AddiUonal Remarke Schedule. may Ae attached if more epace Is raqulred) CANCELLATION City of Fl Collins 287 North Co1legeAve Fort Collins Co aoszz SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCE�LED BEFORE THE EXPfRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISiONS. AUTHORIZED REPRESENTATIVE �.�at�lu�t,V1.'�- O 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 {2616103) The ACORD name and logo are registered marks of ACORD �'� ACORL7� �� AGENCY CUSTOMER ID: LOC #: ADDITIONAL REMARKS SCHEDULE Page of AGENCY NAMEDINSURE� Moody lnsuranceAgency, Inc. Academy Roofng. In�. POLICY NUMBER CARRIER NAIC CODE EFFECTIVE OATE ADOITIONAL REMARKS THIS ADDITIpNAL REMARKS FORM IS A SCHEbULE 70 ACORD FORM, FORM NUMBER: 25 FORM TITLE: Certificate of Liability Insurence Notes LIA8ILITY APPLIES PER POLICY TERMS AND CONDITIONS LeasedlRented Policy Number: EPP0134066 Insurer: Cincinnati Insurance Companies NAIC Code:2000 Ettective Dates: OS10112023 — 05l01l2024 $150,000 Limil/51,000 Deductible Installalion Floaler Policy Wumber: EPPU134068 Insurer: Cincinnati Insurance Companies NAIC Code:2000 ENeclive Dates: 0510112023 — 05f0112024 $500,000 Limil COniractors P011uti0n Policy Number: CSP305034 Insurer: Colony Insurance Company NA1C Code:39993 Effeclive Dale: 05lQ112Q23 — 05l01/2024 $7,0o0,000 Limil {Includes Mold Coverage) PoliCy FOrm CPL001-0615 InCludeS: Blanket Addiiional Insured status when required by written conlrect. Coverage applies as Pnmary and Non-contribulory when required by writlen contraG Blanket Warver of Subrogation applies when reqwred by wrilten contract Generat Liab�lity GA 233 0920 F orm AltaChed Inc udeS: Blanket Additional Insured slatus applies only lo the exlent provided in form GA 233 CO 0920 when required by wnden contracl. Blanket Warver c( Subrogation applies only to the exlent provided 'n form GA 233 0920 when required by written contract. Primary and Non-ConUibulory status only to Ihe extent provlded i� (orm GA 233 CO 0511 when requ red by wrilten conlract. Deslgnated Censtruclion Project(s) General Aggregale Limit provided in form CG 25 D3 O5 09 besignated Location(s) General Aggregate Lim 1 provided in form CG 25 04 p5 03 Auto Liabiliry AA 292 062U Form Attached Inc�udes Blanket Additiana Insured status applies cnly lo the exle�t provided in form AA 292 0920 when required by writien conlrad. Blanket Waiver oi Subrogalion applfes only So the extent prcvided in form AA 292 0920 when required by written conlracl. Primary and Non-Contribulory status only to Ihe extent provided in form AA 292 0920 when required by written contract. Excess Liability: Excess Liability po'icy i5 on a follow torm basis for Ihe following underlying insurance coverages: Generai Liabilily, AuSomobile Liability, and Employers Liability Umbrella follow form. Worker's CompensaCon 359-B From Attached Includes Blanket Waiver of Subrogation. Status applies when required by written contract. IMPORTANT The policy forms referenced will be sent via ema I only. To oblain copies, please send your request wilh the emai! address to ceArequest@moodyins.com ACORD 101 (2008/01) O 20a8 ACORD CORPORATIQN. Atl rights reserved. The ACORD name and loga are registered marks of ACORD