HomeMy WebLinkAboutCOTTONWOOD DRYWALL - INSURANCE CERTIFICATEAC CERTIFICATE OF LIABILITY INSURANCE OP ID R DATE(MMID
/13 W)
OTTO-4 0213/04
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
Linden/Bartels & Noe Agency FC HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
1614 Oakridge Drive, Unit A ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Fort Collins CO 80525
Phone:970-229-9304 Fax:970-229-1398 INSURERS AFFORDING COVERAGE
INSURED INSURER A. Pinnacol Assurance
INSURER B
Cottonwood D yw all , Inc.
125 Starbright Court INSURER C:
P.O. Box 423 INSURER D.
Wellington CO 80549
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 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
LTR
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
DATE MM/DDlYY
POLICY EXPIRATION
DATE MMIDDIYY
LIMITS
GENERAL LIABILITY
COMMERCIAL GENERAL LIABILITY
CLAIMS MADE OCCUR
EACH OCCURRENCE
$
FIRE DAMAGE (Anyone fire)
$
MED EXP (Any one person)
$
PERSONAL & ADV INJURY
$
GENERAL AGGREGATE
$
GEN'L AGGREGATE LIMIT APPLIES PER:
POLICY PRO LOC
JECT
PRODUCTS - COMP/OP AGG
$
AUTOMOBILE
LIABILITY
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON -OWNED AUTOS
COMBINED SINGLE LIMIT
(Ea accident)
$
BODILY INJURY
(Per person)
$
BODILY INJURY
(Per accident)
$
PROPERTY DAMAGE
(Per accident)
$'
GARAGE LIABILITY
ANY AUTO
AUTO ONLY - EA ACCIDENT
$
OTHER THAN EA ACC
AUTO ONLY: AGG
$
$
E%CEBB LIABILITY
OCCUR CLAIMS MADE
DEDUCTIBLE
RETENTION $
EACH OCCURRENCE
$
AGGREGATE
$
$
$
A
WORKERS COMPENSATION AND
EMPLOYERS'LIABILITY -
4066596
03/01/04
03/01/05
3C I TORY LIMITS I I ER
E.L. EACH ACCIDENT
$500,000
E.L. DISEASE - EA EMPLOYEE
$500,000
E.L. DISEASE -POLICY LIMIT
s500,000
OTHER
DESCRIPTION OF OPERATIONSILOCATIONSA/EHICLESIEXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
All Operations - All Location. Co -Employment Endorsement/The Employer
Source.
CERTIFICATE HOLDER I N I ADDITIONAL INSURED; INSURER LETTER: CANCELLATION
CITYOFF
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN
City OP Fort Collins
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
Contractor Licensing
Jan/Purchasing
PO BOX 580
IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UP N T TS AGENTS OR
REPRESENTATIVES. j
AUTHORIZED REPRESENTATIVE .µ
Ft Collins CO 80522-0580
I
Michael D. Pierce x- ----.-
ACORD 25-S (7197) UAGORD GURPURATIUN 1936