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Home My WebLink AboutACC ROOFING INC - INSURANCE CERTIFICATE (2)12/072007 09 57 970-484-2945 Daniel Richmond Agency Page 22 CERTIFICATE OF LIABILITY INSURANCE American Family Insurance Company ❑ American Family Mutual Insurance Company if selection box is nth chef ked 6000 Amercan Pky Madison, Wlsrznsin 53783 0001 Insured s Name and Address Agents Name, Address and Phone Number (Agi /Dist ) ACC Roofing Inc 1713 E Lincoln Ave Unit 33 Fort Collins CO 80524-4727 Daniel B Richmond (970) 484-2881 923 E Prospect Rd Fort Collins, CO 80525-1110 (005/316) This cerhffcate is issued as a matter of information only and confers no rights upon the Certificate Holder This certificate does not amend, extend or alter the coverage afforded by the policies listed below COVERAGES I ' Tine is to teddy in at policies of a surelra Il stied W it bass Caen issued to IM1e insurnJ.'—ad abwa for IIC Miry period turbaned netwNptdad is airy agoammt firm pr mid l¢ln of my Lon4ad Is other Jaua l wdin noticed to eh Me obeficate may beissued O' mat pgtam the onaral afforded by IM1e pesoCe desoibCd bHeni6 sassed In all IM1e Io-ml..,mb Gras aM Wnati of noth polices TYPE OF INSURANCE POLICY NUMBER pint try nATF LIMITS OF LIABILITY tEEEcIIYE H i I 10N (Mo. Da Yr Me Day. Yr Homeowners/ Gaddy Injury and Properly Damage Mobilehomeowners Liability Each IS- ....r'« $ ,DDO Boatowners Liability Sol lnluy and Properly Damage Each occurmmsi $ ,000 Personal Umbrella Liability Bol In and Property Damage Ease Occurrence $ ,000 hmm Liability & Persmol Lesldy Farm/Ranch Liability Each Occurmme $ 000 Farm Employer a Liability Each Ocourrema $ 000 Workers Compensation and Still Each Ardent $ „000 Employers Liability t aaesse Each Employee $ 000 usease Polly umd $ '000 General Liability General Aggregate S 2,000 000 Re]acb completed Operations Aggrege e $ 2 00 ,DDD ® Commercial General Liability (occurrence) ❑ OS-XF9581-08-00 5/24/2007 5/24/2008 Personal and Mveressn lour $ 1,000 DOO Eaton economics $ 1 000 000 ❑ D.11alon, 1pmeaea Ral to You $ 100 000 Medical Expense (My One Person) $ 5 ogD Buslnessowners Liability Each oav"enmtt $ ,DOO AggreglAatt $ 000 Liquor Liability common eaesis Lmn $ ,DOO Aggregate Lmrl $ Don Automobile Liability soddv enury Eom Person $ 1,000 '000 ❑ Any Auto ❑ All Owned Autos sndllylnlvy Eel Actol $ 1,000 ,000 $ m Scheduled Autos 05-XF9581-02-00 6/18/2007 6/18/2008 ® Hired Auto boron, Damage 10000 000 [WIO NODOWfIed Autos Boddylnluryand Pmceny Deraageoambeed $ '000 Excess Liability ❑ Commercial Blanket Excess Each Occurranc1A,x'.fe $ ,000 Other (Miscellaneous Coverages) DESCRIPTION OF OFIERATIOl ILOCATIONS/ VEHIIRESTRICTIONS I Sli ITEMS tTbe rndndual or penners shorn ns msve0 ❑Have ❑Havens The commercial general liability coverage part is endorsed to include The City of pleaded to be cowmd as cmleloyess under this policy Ft Collins as additional insured on the CG 20 12 07 98 endorsement - llscensin t t Nobel completed operations aggregate is eguai to each 9 ocgnrence limit andis a dusedm Mholrogregata CERTIFICATE HOLDER'S NAME AND ADDRESS CANCELLATION • Cityof Fort Collins Should any of the above described polices, be cancelled before the '( exPration date thereof the company wit endeavor to mail 30 days) Purchasing Dept written notice to the Certificate Holder named, but failure to mad such 215 INMason St notice shall impose no obligation or liability of any land upon the - y0 Fort Collins Co 80522 company, its aBerns or representatives days unless different number of days shown O This certifies coverage on the date of issue only The above described policies are subject to cancellation in con or nny with their terms and by the laws of the state of issue DATE I ED AUTH REDREP NTATN 12/7/2007� U-201 Ed 6IDO Certificate Holder Stock No 06668 Rev 7/02