HomeMy WebLinkAboutRoche Constructors Inc - Insurance Certificate 2025 A6 ® CERTIFICATE OF LIABILITY INSURANCE FDATE(MMIDD/YYYY)
12/23/2024
THIS CERTIFICATE 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 NAME: T Vella Mancha
Holmes Murphy&Associates PHONE 1 FAX
2727 Grand Prairie Parkway A/c No:
IL
Waukee IA 50263 ADDRESS: vmancha holmesmur h .com
INSURERS AFFORDING GOVERAGE NAIL 8
INSURER A:National Fire Insurance Co of Hartford 20478
INSURED ROCCONPCI INSURER B:The Continental Insurance Company 35289
Roche Constructors, Inc.
361 71st.Avenue INSURERC:American Casualty Company of Reading PA 20427
Greeley, CO 80634 INSURERD: Indian Harbor Insurance Company__ _ _____ 36940
INSURER E:
INSURER F:
COVERAGES CERTIFICATE NUMBER:63119144 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.
LTR
POLICY EFF i POLICY EXP -
ILTR, TYPEOFINSURANCE LIMITS
IN SD:.WVD i POLICY NUMBER MMlDD/YYY i MMlDDIYYYY i
A X COMMERCIAL GENERAL LIABILITY 7063686749 1 1/1/2025 1/1/2026 ! EACH OCCURRENCE $1,000,000
�_ AM GE To
RENTED
CLAIMS-MADE �J OCCUR PREMISESSEaoccurr-a— $500,000_
X PO Ded$3.000 MED EXP(Any one person) $15.000
PERSONAL&ADV INJURY $1,000,000
GEN'L AGGREGATE LIMIT APPLIES PER: ! GENERAL AGGREGATE $2,000,000 _
POLICY!l X PRO-- !i X LOG I PRODUCTS-COMP/OPAGG $2,000,000JECT
'
OTHER: $
B AUTOMOBILE LIABILITY I 7063686766 1/1/2025 ! 1/1/2026 {EaaoatleDISINGLE LIMIT $1.000.000
__... ------------- -- ---
X ANY AUTO BODILY INJURY(Per person) $
OWNED SCHEDULED
AUTOS ONLY AUTOS BODILY INJURY(Per accident) $
X HIRED X NON-OWNED PROPERTY DAMAGE $
AUTOS ONLY AUTOS ONLY Per accident-
$
B X UMBRELLALIAB X I OCCUR 7063686783 1/1/2025 1/1/2026 EACHOCCURRENCE $10,000,000
EXCESS LIAR CLAIMS-MADE ! AGGREGATE $10,000,000
DED ! X RETENTION$n $
B WORKERS COMPENSATION 7063686752 1/1/2025 1/1/2026 X I
PER OTH•
AND EMPLOYERS'LIABILITY STATUTE ER
ANYPROPRIETORiPARTNERIEXECUTIVE Y/N ! I E.L.EACH ACCIDENT $1,00_0,000
OFFICE RIME ME ER EXCLUDED? a!NIA! l
(Mandatory in NH) ! E.L.DISEASE•EA EMPLOYEE $1,000,000
II yes,describe under
DESCRIPTION OF OPERATIONS below ! E.L.DISEASE•POLICY LIMIT $1,000,000
C Leased/Rented Equipment 7034761981 1/1/2025 1/1/2026 $500,000 Limit $5,000 Deductible
D Pollutlon/Professional Llab CE0744657508 1/1/2025 1/1/2026 $5Mil ClaimlAggregate $25,000 Retention
i I
i
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required)
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
City of Fort Collins;Building Department ACCORDANCE WITH THE POLICY PROVISIONS.
P.O. Box 580
Fort Collins CO 80521-0000 AUTHORIZED REPRESENTATIVE
USA
V
01988-2015 ACORD CORPORATION. All rights reserved.
ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD
14595: 2 ' of 2