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HomeMy WebLinkAboutPrimo Installations LLC - Insurance Certificate ACC)R"® CERTIFICATE OF LIABILITY INSURANCE 72/z1/2o 5Y' 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 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 NAME: Katie Klimek Ewing-Leavitt Insurance Agency, Inc. PHONE (970)679-7333 FAX (866)456-4265 N Ex A/C,No): 5689 McWhinney Blvd. EMAIL ADDRESS: katie-klimek@leavitt.com INSURERS AFFORDING COVERAGE NAIC# Loveland CO 80538 INSURERA:Selective Insurance Group, Inc. 12572 INSURED INSURER B:Pinnacol Assurance 41190 Primo Installations LLC INSURERC: 1005 Lilac Drive INSURER D: INSURER E Lochbuie CO 80603 INSURERF: COVERAGES CERTIFICATE NUMBER:25-26 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 CONTRACTOR 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 POLICY EFF POLICY EXP LTR TYPE OF INSURANCE POLICY NUMBER MM/DD/YYYY MM/DD/YYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A CLAIMS-MADE X❑OCCUR DAMAGE TO RENTED 50,000 PREMISES Ea occurrence $ X Blkt Additional Insured S2505088 2/21/2025 2/21/2026 MED EXP(Any one person) $ 10,000 X Blkt Waiver of Subrogation PERSONAL &ADVINJURY $ 1,000,000 GEN'LAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY JET LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: $ AUTOMOBILE LIABILITY COM Ea aBINEDtSINGLE LIMIT $ 1,000,000 A X ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS S2505088 2/21/2025 2/21/2026 BODILY INJURY(Per accident) $ X X NON-OWNED PROPERTY DAMAGE HIRED AUTOS AUTOS Per accident $ X Blkt Addtl Insd X Blkt Waiv of Subgt $ UMBRELLALIAB N OCCUR EACH OCCURRENCE $ 2,000,000 A X EXCESS LIAB CLAIMS-MADE AGGREGATE $ 2,000,000 RED RETENTION$ None S2505088 2/21/2025 2/21/2026 $ WORKERS COMPENSATION X PER OTH- AND EMPLOYERS'LIABILITY YIN STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? FN] N I A B (Mandatory In NH) 4242304 3/1/2025 3/1/2026 E.L.DISEASE-EA EMPLOYEE S 1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below I I Blkt Waiver of Subrogation I I E.L.DISEASE-POLICY LIMIT $ 1,000,000 _T DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) The City of Fort Collins is named as additional insured as respects General Liability. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Fort Collins THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN 281 N College Ave ACCORDANCE WITH THE POLICY PROVISIONS. Fort Collins, CO 80524 AUTHORIZED REPRESENTATIVE Katie Klimek/KAKLIM ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD INS025(201401)