HomeMy WebLinkAboutB SHARP CONSTRUCTION - INSURANCE CERTIFICATEACORD� CERTIFICATE OF LIABILITY INSURANCE
DATE1/30/04
1 /30/04
PRODUCER 206-701-5000
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Acordia
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
CA License # 0531007
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
P.O. Box 91143
Seattle, WA 98111-9774
INSURERS AFFORDING COVERAGE
INSURED
B Sharp Construction
INSURER A: Underwriters at UoVd'S
Attn: Darci Sharp
INSURER B: Safeco Insurance Companies
1302 N. 30th
INSURER C:
Renton WA 98056
INSURER D:
INSURER E:
rnvooer_cc
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 POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH
POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR
TR
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
DATE IMMIDDNYI
POLICY EXPIRATION
DATE (MMIDDNYI
LIMITS
A
17
GENERAL LIABILITY
X COMMERCIAL GENERAL LIABILITY
CLAIMS MADE 51 OCCUR
CJ0426026
2/01 /04
2/01 /05
EACH OCCURRENCE
$ 1000000
FIRE DAMAGE (Any one fire)
S 100000
MED EXP (Any one person)
$ 5000
PERSONAL& ADV INJURY
S 1000000
GENERAL AGGREGATE
$ 2000000
GEN'L AGGREGATE LIMIT APPLIES PER:
POLICY PRO- 1-1 LOC
PRODUCTS - COMP/OP AGG
$ 2000000
B
AUTOMOBILE
LIABILITY
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON -OWNED AUTOS
02CE05866301
2/01 /04
2/01 /05
COMBINED SINGLE LIMIT
(Ea accident)
$ 1000000
X
BODILY INJURY
IPer person)
$
BODILY INJURY
(Per accident)
$
PROPERTY DAMAGE
(Per accident)
$
GARAGE LIABILITY
ANY AUTO
AUTO ONLY - EA ACCIDENT
$
OTHER THAN EA ACC
AUTO ONLY: AGG
$
$
EXCESS LIABILITY
OCCUR CLAIMS MADE
DEDUCTIBLE
RETENTION $
EACH OCCURRENCE
$
AGGREGATE
$
8
$
$
A
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY
WA STOP GAP
CJ0426026
2/01l04
2l01/05
TV
ORV LIMITS OER
E.L. EACH ACCIDENT
$ 1000000
E.L. DISEASE - EA EMPLOYEE
$
E.L. DISEASE - POLICY LIMIT
S
OTHER
DESCRIPTION OF OPERATIONS/LOCATIONSIVEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
Proof of Insurance
is
CERTIFICATE HOLDER I I ADDITIONAL INSURED: INSURER LETTER: CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
City of Ft. Collins
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN
281 N. College Avenue
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
Ft. Collins, CO 85022
IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
REPRESENTATIVES.
AUTHORIZED REPRESENTATIVE
C
ACORD 25-S (7/97)
11- 56
U( ,CO"ORPORATION 1988
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, 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.
ACORD 25-S (7197)