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Home My WebLink AboutACC ROOFING - INSURANCE CERTIFICATE (3)P/NN/ICOL ASSURANCE CITY OF FORT COLLINS 215 NORTH MASON FORT COLLINS CO 80522 INSURED: ACC ROOFING INC 918 WEST MULBERRY ST FORT COLLINS CO 80521 i0l E Lowry Bivd enver, CO 80230-7006 Nw.pinnacol.com UCLOoer i -1, t006 Policy #: 4081645 AGENT: CONSOLIDATED AGENCIES/DANIEL INS AG 2627 REDWING RD, SUITE 330 FORT COLLINS, CO 80524 (970)223-5902 Rescinding Pending Cancellation Notice To Certificate Holder The policy for: Policy #: 4081645 Insured: ACC ROOFING INC is in good standing with Pinnacol Assurance. The October 12, 2006 notice of cancellation has been rescinded. As always, Pinnacol Assurance continues to be Colorado's premier workers' compensation insurance company. If you have any questions regarding this letter, or if I can be of further help, please contact me at the numbers listed below. Sincerely, Nichole Valdez, Underwriter Phone:(303) 361-4475 / (888) 852-2268 Fax: (303) 361-5450 / (888) 329-2210 UM02B 13 OCr 1(X10 I&. 17,27 *)81W Uplaw 13; W I e IM-0 P/NN/I COL ASSURANCE CITY OF FORT COLLINS 215 NORTH MASON FORT COLLINS CO 80522 INSURED: ACC ROOFING INC 918 WEST MULBERRY ST FORT COLLINS CO 80521 7501 E Lowry Blvd Denver, CO 80230-7006 www.pinnacol.com October 12. 2006 Policy #: 4081645 AGENT: CONSOLIDATED AGENCIES/DANIEL INS AG 2627 REDWING RD, SUITE 330 FORT COLLINS, CO 80524 (970) 223-5902 Notice To Certificate Holder Of Pending Cancellation Pinnacol Assurance would like to inform you that the workers' compensation insurance policy through our company for: Policy #: 4081645 Insured: ACC ROOFING INC for whom you currently hold a certificate of workers' compensation insurance, is scheduled to terminate as of October 31, 2006. If the insured listed above elects to maintain the policy, we will send you a notice rescinding the cancellation. As always, Pinnacol Assurance continues to be Colorado's premier workers' compensation insurance company. If you have any questions regarding this letter, or if I can be of further help, please contact me at the numbers listed below. Sincerely, Nichole Valdez, Underwriter Phone:(303) 361-4475 / (888) 852-2268 Fax: (303) 361-5450 / (888) 329-2210 LIM11B 12 OQ 2NM 181052 4181W b,m.wl 12AMl 6 P71Q "l a� ' CERTIFICATE OF LIABILITY INSURANCE Amerian Fsn* Abe Company ❑ Alnalan Famly Mutual kwurenos Company Y ttabgMon box Is not dleaksd. ww Artodow Pky Medbon. wl5cora 637830W1 hound's Nwm and Address Agarrt's Hans, Addeme and Phone Number (ApIrDbL) ACC RoWng Inc. Daniel B Richmond (970) 484-2881 918 W Mulbo" St 923 E. Prospect Rd Fad Coft-M, CO 8052i-3M Fort Collins, CO 80525-1110 (005-MB This arVilesle le Iatued r a rrra/br at Ydonnation only and carders ns ripbb upon Ms Card"cats lk*m This cardlicala dome not amarld, etderml or allar tbs aswrgp afforded by do policies Naiad bakm. Tiesabddle/artpaeob ar.Yrrurloe alai baba rbm been eemdtoer bandnandabbwrase psrq pand bararsd. rroesMearrane owmgdresr mtsarraroadbn darbr caressasMa dmmwiwr mpoa baN*Moaarale m" b o bamdor mW psrlrK me baraarm rea4d ba ps pmwdn~ Ile W Y alwd 10a1M bm %aababr, aw mAked WMp0ftmL TYPE OF MIRMICE POLICY NtNfiowt LBARB OF I IABNJTY morrdwaneral moidbhannotsrrsn Lh btuy .000 Bodorn»rsLbbft stay "*r+d owsp Erhamaadre s .000 Personal Un*rela Umbi ft soak M rY sM AOPab Each Omraams $ .000 FBMMMcb LbbMIy FAM Emb a 000 Each commmmm brrr a mo Wort M Cempenaadon end ftsplayers 1.1 bMV i sft"y ► E"AOMM a .000 Vbmw-raelremspaym a .000 pmm-phew lma a .000 General bift 04ftAd n e S 2,000,000 Pmaaar • 3 2,000 000 IS Iebl� General PWSN a" a 1,000 Lbb(oocummee) ❑ tiity ❑ 05 XF9581 01 5/2412008 5124/2007 umm $ t 000 � �� SaminRendw FamftoioYm a 100 Medea Orr Wrarl >; 5 BwbMmeoeswaLbbift radrommenmtt S '000 AW%owtt a .000 Oamren Comwt a 000 teal s ;pop AulbrnobleLbbMly ❑ Any Auto ❑ ANOMWAulae Soft h#.y-EA Pam a 1,000.000 sakbbWr- Each Aeddas a 1,000,wo rMPabDK4 S 1,000,000 IM 8elndubdAutm ® Hired Auld 05-XF9581-02-00 61182006 61IM007 00ftk* wWPmM%00*M erbnebsd a .000 M NOM nrad Aube ❑ Excess lJablfaty ❑ Commercial OW" Excess Each acmwwcMAppspms $ .000 OdrM IMbcedsnean Ca enesal t Tlm erdblanl aperbwe sham so haead 0 Ham ►Mm mt The comnarddpanaal sablay eorsrabe in endoraW to bdude The Coy of Fort CObins as eMbional insured ebded b ba mmmd r arobleee mderelts poeq. on the CO 20 12 071 S endomamad - permits t t Pm*m& Qmprded OpaaNns owns'" is aw to mm ooasr mlimbslidakckAelbrft aeetaprb. . The Gty of Fort Collins � 0meGdt Me g0N �pby��" bt (io , I P O BOX 580 Itnar, b the Certlk m r nitoa�n�edtv, but iaRue m mall eudl Fort C010ne Co 80522 � ol sp , oorno �tadves. days trisaat ebmMMent rroovovmamps 224-6134 ❑mTohiiss oerbMme'adop an the Osb Of lseus only. The above The by i the�abb io ofcwmbtbn Inmnformiy wlth owk 10y7J2008 U�M Ed.droo CerWicate HoMor Sbbk No. 06eea Rev. 71M AY/YL!EVWt1 41:1JAn EA2nnACO1 ASsuraBnce I+AUr z ur a CERTIFICATE OF LIABILITY INSURANCE 1a02r2oo6 AV30" Plmeeol A swar@@e InKI YCn l lny 'C Ii I WGUA A MF11 ICn Tlr OWWW ift IWn WMT AND CONFERS NO RIGHTS UPON THE CERTIFICATE HWflll. THIS 7601 E Lowry Swd CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE DENVER CO 80230.7006 AFFORDED BY THE POLICIES BELOW. INSURERS AFFORONG COY GE NAIL Inaunne ACC ROOFING INC MUM SIB WEST MULBERRY ST YPNYI e: FORT COLLINS CO 60621 aOYEEAOEt THE POLICIES OF INSURANCE LISTED BELOW HAVE WIN IBBUEO TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REOUI REMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY N ISSUED OR ,- MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH W12 "ION MAY Vi BEgI 16 O BY PAID CLA I-1 O@@l LIN AMR Wm "M OF IMAW= MAZY liu T FDYCY QF@@TIIN OATN/ANOOM 11 IOMY INAYATNIR DATMMJM"YTI u@@TN ' OLXWA1 UMWT COMMYnCIN.MR@@ALRA@Yn OAINNNNON ❑ OCCRR I IACROCCWMMM OARAM TOANR/@@ N@@@@me./. OW iADVI oNNI TN UVIT INC Loc RWMTN. comwAM I ANOH@NILWNR AN/ AUTO ML DWMe AMfM SCMDU O ARTON 1{ISD JJnlas W"WMD ANION _ commowuuw A. tofiY IRAN" IAn SOOLY RWIM Iti.,Ad" RWMTV DAYAON (ft We. WYIWUN w" Ann Alva AN 0 @ Pay •a At W onm TRAn Impolay. me EISFKORRRfuAUMI}if RAM earn ❑ cLrMN Dowries "OR DA A I/D comomM@@RAar mwmrwAluww AIS TmRu umemetut mA o/NC/IIWIANRI%CNApt 0 -m w hm"W40Ov &parmoombdp 1481eJ15 061,0112008 0810112007 Kj WC IMAM U On= El Mcw Ef t1000 000 1 A..Y10AM.MUCYLWT 1 01000000 Nlar @@@Darren OF OPOLWO R/LOOWK /VMIWN/ismini NA00bn sewomn~ IYOWL INONNIYM SEE BACK OF CERTIFICATE FOR CLAN COVERAGE AND OWWRENI COVERA0i DETAIL 1 1. I TE HOLDER S 94ow SHOULD ANY OF THE ABOVE DESCRIBED POLICIES N CANCELLED BEFORE THE OF FORT COLLINS EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL `CITY 21E NORTH MASON 10 DAYS WRTNTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT. .I FORT COLLINS CO ON22 BUT FAILURE TO MAIL SUCH NOTICE SHALL MPDBE NO OIILISATRMN OR LIABILITY OF ANY KIND URN THE COMPANY, ITS AGENTS OR NMENTATIVI AWN0I1111E0 BEET uw7Alm n Nichole Valdez 2s 1 Undorwriter ACIM CQRPDW7M TEN RMYAWYY,w.I /NMFRwApY IY@ld II:L�Aa A@@IY IYiI.f. 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