HomeMy WebLinkAboutSCHROEDER ROOFING - INSURANCE CERTIFICATEACORDM CERTIFICATE
OF LIABILITY INSURANCE
ATE
D 05/31/2007 I
PRODUCER
Serial # A3485
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
COLORADO WORKERS'
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
COMPENSATION NETWORK, INC
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
6635 S. DAYTON ST, SUITE # 240
GREENWOOD VILLAGE, CO 80111
INSURERS AFFORDING COVERAGE
NAIC#
INSURED
INSURER A: PINNACOL ASSURANCE
INSURER B:
SCHROEDER ROOFING CO.
INSURER C:
1300 NORTH MONROE AVENUE
INSURER D:
LOVELAND CO 80537
INSURER E:
COVERAGES
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 POLICES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH
POLICIES, AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
TR
NSRL
TYPE OF INSURANCE
POLICY NUMBER
POLICY MM/DDNV
POLICY
MM/DD/YYI
LIMITS
GENERAL LIABILITY
EACH OCCURRENCE
$
COMMERCIAL GENERAL LIABILITY
CLAIMS MADE OCCUR
DAM^AGETOISES E RENTEPRE D
$
MED EXP (Any me person)
9
PERSONAL&ADV INJURY
$
GENERAL AGGREGATE
$
GEN'L AGGREGATE LIMIT APPLIES PER
PRODUCTS - COMPIOP AGG
$
POLICY PRO-
JECT LOC
AUTOMOBILE LIABILITY
ANY AUTO
COMBINED SINGLE LIMIT
(Ea accident)
$
BODILY INJURY
(Per person)
$
ALL OWNED AUTOS
SCHEDULED AUTOS
BODILY INJURY
(Per accident)
$
HIRED AUTOS
NON -OWNED AUTOS
PROPERTY DAMAGE
(Per accident)
$
GARAGE LIABILITY
AUTO ONLY - EA ACCIDENT
$
OTHER THAN EA ACC
$
ANY AUTO
$
AUTO ONLY: AGG
EXCESS/UMBRELLA LIABILITY
EACH OCCURRENCE
$
OCCUR CLAIMS MADE
AGGREGATE
$
DEDUCTIBLE
$
RETENTION $
A
WORKER'S COMPENSATION AND
EMPLOYERS' LIABILITY
ANY PROPRIETOR/PARTNER/EXECUTIVE
4030163
6/01/2007
06/01/2008
1 TORVLIMITS X OER
EL EACH ACCIDENT
$ 500,000
EL DISEASE - EA EMPLOYEE
$ 500,000
OFFICER/MEMBER EXCLUDED?
If
SPECdescribe u der
AL PROVISIONS below
EL DISEASE - POLICY LIMIT
Is 500,000
OTHER
DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
CERTIFICATE HOLDER
CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
CITY OF FORT COLLINS
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN
PO BOX 580
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
FORT COLLINS CO 80522
IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
REPRESENTATIVES.
AUTHORIZED REPRESENTATIVE THOMAS SOEHNGEN
n.
ACORD 25 (2001/08) 0 ACORD CORPORATION 1988
IMPORTANT
If the certificate holder is an ADDITIONAL INSURED, the policy(les) must be endorsed. A statement
on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
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).
DISCLAIMER
The Certificate of Insurance on the reverse side of this form does not constitute a contract between
the issuing Insurer(s), authorized representative or producer, and the certificate holder, nor does it
affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon.
25