HomeMy WebLinkAboutBELL ROOFING - INSURANCE CERTIFICATECERTIFICATE OF LIABILITY INSURANCE
American Family Insurance Company ❑
American Family Mutual Insurance Company if selection box is not checked.
6000 American Pky Madison, Wisconsin 53783-0001
Insured's Name and Address Agent's Name, Address and Phone Number (Agt./Dist.)
Bell Roofing, Inc Kathy A. Collins (970) 225-6866
Erik Belmaraz 1119 W Drake Rd Ste C-28
418 SE 8th St Unit A-7 Fort Collins, CO 80526-2476 (139/309)
Loveland, CO 80537
This certificate 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.
�+(iVE�aSGES `
This is to certify that 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 policies described herein is subject to all the terms, exclusions, and conditions of such policies.
POLICY DATE
TYPE OF INSURANCE
POLICY NUMBER
LIMITS OF LIABILITY
EFFECTIVE EXPIRATION
(Mo.Da Yr (Mo.Da Yr
Bodily Injury and Property Damage
Homeowners/
MobilehomeownersLiability
Each occurrence $ '000
Bodily Injury and Property Damage
Boatowners Liability
Each Occurrence $ ,000
Bodily Injury and Property Damage
Personal Umbrella Liability
$ 000
Each Occurrence
Farm Liability & Personal Liability
Farm/Ranch Liability
Each Occurrence $ '000
Farm Employers Liability
$
Each Occurrence 000
Workers Compensation and
Statutory **+*++****+*
Each Accident $ '000
Employers Liability t
Disease - Each Employee $ ,000
Disease - Policy Limit $ ,000
General Aggregate $ 2,000 000
General Liability
® Commercial General
Products - Completed Operations Aggregate $ 2,000 ,000
Personal and Advertising Injury $ 1,000 .000
Liability (occurrence)
2/13/2004
2/13/2005
Each Occurrence $ 1,000,000
❑
Damage to Premises Rented to You $ 100 000
❑
Medical Expense (Any One Person) $ 5 o00
Each Occurrencet t $ ,000
Businessowners Liability
Aggregatett $ ,000
Common Cause Limit $ ,000
Liquor Liability
Aggregate Limit $ '000
Automobile Liability
Bodily Injury- Each Person $ 000
❑ Any Auto
Bodily Injury -Each Accident $ QQQ
❑ All Owned Autos
Property Damage $ ,000
❑ Scheduled Autos
❑ Hired Auto
Bodily Injury and Property Damage Combined $ 000
❑ Nonowned Autos
❑
Excess Liability
❑ Commercial Blanket Excess
Each Occurrence/Aggregate $ ,000
Other (Miscellaneous Coveraaes)
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES I RESTRICTIONS I SPECIAL ITEMS t The Individual or partners shown as insured ❑ Have ❑ Have not
Roofing elected to be covered as employees under this policy.
t t Products -Completed Operations aggregate is equal to each
occurrence limit and is included In policy aggregate.
CERilFIC0.t1w}IOf t?@13NAIuIR'ATII ADDE;ES.
CANjGEf t ATIfJN
City of Fort Collins
LJ Should any of the above described policies be cancelled before the
date thereof, the company will endeavor to mail'( days)
•
300 Laporte Ave
expiration
written notice to the Certificate Holder named, but failure to mail such
Fort Collins, CO 80521
notice shall impose no obligation or liability of any kind upon the
company, its agents or representatives. *10 days unless different
number of days shown.
® This certifies coverage on the date of issue only. The above
described policies are subject to cancellation in conformity with their
terms and by the laws of the state of issue.
DATEISSUED
AUTHO ZED R RESE f
?/16/2004
U-201 Ed. 5100 Certificate Holder ZV Stock No. 06668 Rev. 7/02