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HomeMy WebLinkAboutVillalobos Construction, LLC - Insurance Certificate 2024 A ® DATE(MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 12/26/2024 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). NTACT PRODUCER NAME: Shand Tamayo _ CRS Insurance Brokerage PHONE 303 996 7800 I ac No):303 757-7719 9780 S Meridian Blvd Suite 400 E-MDDAIL Englewood CO 80112 ARE s: stamayo@crsdenver.com _ IN5URER(5)AFFORDING COVERAGE NAIL N INSURER A: Selective Ins.Co.of America 12572 INSURED VILLCON-02 INSURER B: Villalobos Construction, LLC 5023 W. 120th Ave.#327 INSURER C: Broomfield CO 80020 iNSURea_D-_..__ INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:2061413399 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. INSIR!, TYPEOF INSURANCE N Dli W�R POLICY NUMBER MM DDIYYYF MM/DD/YYYY LIMITS LTR A X COMMERCIAL GENERAL LIABILITY i S 2324689 12/31/2024 j 12/3112025 EACH GE OCCURRENCE $1,000,000 DAMA R T CLAIMS-MADE L� OCCUR PREMISES(Ea occurrence) $500,000 _ MED EXP(Any one person) $15,000 L PERSONAL i3 ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2.000,000 _ AT POLICYI X ;JE� L j LOC i PRODUCTS-COMP/OPAGG $2,000,000 OTHER: $ A AUTOMOBILE LIABILITY S 2324689 12l31/2024 12/31/2025 COMBINED SINGLE LIMIT $1,000,000 _ Ea acadenl X ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY j AUTOS HIRED I NON-OWNED PROPERTY DAMAGE $ X AUTOS ONLY AUTOS ONLY (Per accidanq $ A UMBRELLA LIAB H OCCUR S 2324689 12/31/2024 12131/2025 EACH OCCURRENCE $2.000,000 X EXCESS LIAB CLAIMS-MADE i AGGREGATE__— $2,000,000 DED X RETENTION$n $ WORKERS COMPENSATION i PER 1 1 OTH- AND EMPLOYERS'LIABILITY I STATUTE ER ANYPROPRIETOR,'PAR7NER/EXECUTIVE Y/N E.L.EACH ACCIDENT $n/a OFFICERWEMBEREXCLUDED? NIA ! ------- — — (Mandatory In NH) I E.L.DISEASE-EA EMPLOYEE $n/a II yes,describe under DESCRIPTION OF OPERATIONS below I E.L.DISEASE-POLICY LIMIT $n/a A Wand Marine S 2324689 jl 12/31/2024 I 12/31/2025 -i Leased/Rented Equip 100,000 Scheduled Equipment 751,665 Deductible 1,000 j DESCRIPTION OF OPERATIONS/LOCATIONS r VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Certificate holder is included as additional insured on the General Liability with respect to ongoing and completed operations of the named insured for the certificate holder as required by written contract.All policy terms,conditions and exclusion apply. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of Fort Collins Attn: Engineering Dept. 281 N. College Ave AUTHORIZED REPRESENTATIV Fort Collins CO 80524 OKI 01988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD 10494: 2 ' of 2