HomeMy WebLinkAbout109315 COLORADO DOORWAYS INC - INSURANCE CERTIFICATE (3)`..�1p _
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7501 E Lowry Blvd
Denver, CO 80230-7006
Phone: (303) 361-4000 / (800) 873-7242
Fax: (303) 361-5000 / (888) 329-2251
NCCI #: WC000313B
Policy #: 3142569
INSURED: AGENT:
COLORADO DOORWAYS INC THOMAS J SISK & CO, INC
%JANICE BAUMGARTNER (PERSONAL & CONFI 1700 BROADWAY, SUITE 1000
3333 EAST 52ND AVENUE DENVER, CO 80290
DENVER CO 80216 (303) 831-7100
ENDORSEMENT: Blanket Waiver of Subrogation
We have the right to recover our payments from anyone liable for any injury covered by this policy. We will not
enforce our right against the person or organization named in the schedule. This agreement applies only to the
extent that you perform work under a written contract that requires you to obtain this agreement from us.
This agreement shall not operate directly or indirectly to benefit anyone not named in the schedule.
SCHEDULE
To any person or organization when agreed to under a written contract or agreement, as defined
above and with the insured, which is in effect and executed prior to any loss.
Effective Date: September 1, 2007 Expires on September 1, 2008
Pinnacol Assurance has issued this endorsement August 23, 2007.
Sara Beinlich
Underwriter
Pionacal Assurance' 7501 E Lowry Blvd - Denver. CO 80230 -
Page1o11 BEINLICS- Underwriter 08231280718:22:37 3142569 UPdaled: 0510912007 359 9