HomeMy WebLinkAboutHorizon West Builders - Insurance Certificate 2024 AC HORIWES-01 GENEVAD
CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY)
THIS CERTIFIC42/1912024
ATE 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 have ADDITIONAL INSURED provisions or 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).
PRODUCER CONTACT Diane Davis
Mountain West Insurance-Englewood PHONE
3575 S Sherman Street A/C,No,Ext:(303)762-1717 Fvc,No:(303)762-1733
Englewood,CO 80113 E.N'AIL .dianed@mtnwst.com
INSURERS AFFORDING COVERAGE NAIL#
INSURED INSURER A:Employer's Mutual Casualty Company 21415
INSURER B:Pinnacol Assurance 41190
Horizon West Builders INSURERC:
3855 E 151 st Ave
Brighton,CO 80602-7787 INSURER D
INSURER E:
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 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 SUBR
LT1XIncludes
TYPE OF INSURANCE INS D POLICY NUMBER IPOL POLICY EFF POLICY EXP LIMBS
A MERCIAL GENERAL LIABILITY
CLAIMS-MADE �OCCUR X 4X20448 AMAGE TO RENTED EACH OCCURRENCE $ 1,000,000
XCU 4/1/2024 4/1/2025 PREM SES Ea occurrence $ 500,000
MED EXP(Anyoneperson) $ 10,000
PERSONAL&ADV INJURY $ 1,000,000
GEN'L AGGREGATE LIMIT APPLIES PER: 2,000,000
X POLICY El
❑LOC GENERAL AGGREGATE $
OTHER: PRODUCTS-COMP/OP AGG $ 2,000,000
A AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1,000,000
X ANY AUTO $
OWNED X 4X20448 4/1/2024 4/1/2025 BODILY INJURY Per erson
AUTOS ONLY AUTOSULED
X A�RTOS ONLY X NON-
DSIVED BODILY INJURY Per accident
AUTOS ONLY PROPERTY DAMAGE
t
A X UMBRELLA LU1B X OCCUR Per accid en
Excess LIAB CLAIMS-MADE 4X20448 4/1/2024 4/1/2025 EACH OCCURRENCE 3,000,000
DED RETENTION$
AGGREGATE 3,000,000
B WORKERS COMPENSATION X PER OTH-
AND EMPLOYERS'LIABILITY
ANY PROPRIETOR/PARTNER/EXECUTIVE Y/IJ TAIUIE FIR
4088363 1/1/2025 1/1/2026 1,000,000
CEEMBER EXCLUDED? FY N/A E.L.EACH ACCIDENT ManFFIdaR/Mtory In NH)
If yes,describe under E.L.DISEASE-EA EMPLOYE 1,000,000
DESCRIPTION OF OPERATIONS bebw A Equipment 4X20448 E.L.DISEASE-POLICY LIMIT 1,000,000
4/1/2024 4/1/2025 Leased/Rented 75,000
A Equipment 4X20448 4/1/2024 4/1/2025 Scheduled Equip 455,971
DES
OF
TIONS/
Certificate holder OPERATIONS additional insured with respect to ACORD generalional Remarks liability and automobileb6abilitattachy coveragf more e cif required by written contract.
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
The City of Ft Collins THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
Purchasing Department ACCORDANCE WITH THE POLICY PROVISIONS.
PO Box 580
Ft Collins,CO 80522-0580 AUTHORIZED REPRESENTATIVE
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