HomeMy WebLinkAboutACC ROOFING INC - INSURANCE CERTIFICATEACOR " CERTIFICATE OF LIABILITY INSURANCE
DATE(MD9„212007YY' M2DD7
PRODUCER
PINNACOL ASSURANCE
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY
7501 E Lowry Blvd
Denver, CO 80230-7006
AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE
COVERAGE AFFORDED BY THE POLICIES BELOW.
INSURERS AFFORDING COVERAGE NAIC#
INSURED
ACC ROOFING INC
INSURERA PINNACOL ASSURANCE
41190
INSURERS.
1713 E. LINCOLN AVE
wsHRESC
UNIT B3
FORT COLLINS, CO 80524
wSURED.
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 DOCUMMENT 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.
NOR
ADDL
POLIOYEFECTIVE
POLICY EXPIRATION
LIP
INSRD
TYPEOF INSURANCE
P.UCYRLM.P
DATEIMMIDD/WYY)
DATE(MMIOOM'YY)
LIMITS
GENERAL LIABILITY
EACH OCCURRENCE
DAMAGE TO RENTED.
COMMERCIAL GENERALLr LIAEIUTY
CLAIMS MADE OCCUR
PREMISES
MED E%P(Any ane person)
PERSONAL B ADV INJURY
GEN L AGGREGATE LIMIT APPLIERS PER:
GENERAL AGGREGATE
PRODUCTS - COMPIOP AGO
POLICY PROJECT LOC
(_AUTOMOBILE LIABILITY
COMBINED SINGLE LIMIT
ANY AUTO
(Ea Accitlenl)
BODILY INJ URY
ALL OWNED AUTOS
SCHEDULED AUTOS
(Per,--)
BODILY INJURY
HIRED AUTOS
NON-0WNEO AUTOS
(per acclGenl)
PROPERTY DAMAGE
(Peraccltlen0
GARAGE LIABILITY
AUTO ONLY-EAACLIDENT
OTHER THAN EA ACL
ANYAUTO
AUTO ONLY'. AG
EXCE SSNMBRE L(A (ABILITY
EACH OCCURRENCE
I(
OCCUR � CLAIMS MADE
AGGREGATE
I
DEDUCTIBLE
RETENTION $
WORKERS COMPENSATION AND
X WCSTATLL Ll OTHER
A
EMPLOYER'S LIABILITY
ANY PROPRIETOR/PARTNEWE%ECUTIVE
4081645
06/01/2007
06/01/2008
TOW LIMITS
EL EACH ACC I DENT
$1,000, 000
OFFICER/MEMBER EXCLUDED'
EL DISEASE - EA EMPLOYEE
$1,000, 000
ITyes. please tla¢rnbeuntlerSPECIAL PROVISIONS below
EL DISEASE - POLICY LIMIT
$1000000
OTHER
DESCRIPTION OF OPERATIONSILOCATIONSNEHICLESIEXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS
CERTIFICATE HOLDER
CANCELLATION
1014064
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE CITY OF FORT COLLINS PURCHASING DEPARTMENT
THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO
215 N MASON ST
MAIL 0 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE
FORT COLLINS CO 80522
LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR
LIABILITY OF ANY KIND UPON THE COMPANY, ITS AGENTS OR
REPRESENTATIVES.
AUTHORIZED REPRESENTATIVE
Charles Doggett
ACORD 25(2001108)
Underwriter ACORD CORPORATION 1988
CERTIFICATE HOLDER COPY
THE CITY OF FORT COLLINS PURCHASING DEPARTMENT
215 N MASON ST
FORT COLLINS CO 80522
IMPORTANT
If the certificate holder is an ADDITIONAL INSURED, the policy(ies) 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, certian
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.