HomeMy WebLinkAboutCAMPANA CONSTRUCTION - INSURANCE CERTIFICATEACORDa CERTIFICATE OF LIABILITY INSURANCE
09/21/2 0 '
PRODUCER (970)223-0924 FAX (970) 267-2231
Community First Insurance, Inc.
1075 W Horsetooth Rd, Ste 100
Fort Collins, CO 80526
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 BELOW.
INSURERS AFFORDING COVERAGE
NAIC #
INSURED Campana Construction Corp
2020 Lowe, Ste 201
Fort Collins, CO 80526
INSURER A: Colorado Casualty Insurance
41785
INSURER B:
INSURER C:
INSURER D:
INSURER E:
rnVFDA!]F4
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWNTHSTANDIN(
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
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
POLICY EXPIRATION
LIMITS
GENERAL LIABILITY
APOS3987803
09/22/2004
09/22/2005
EACH OCCURRENCE
S 1,000,00
X COMMERCIAL GENERAL LIABILITY
DAMAGE TO RENTED
SPRFUISF S00,000
CLANS MADE O OCCUR
MED EXP (Any one person)
$ 5 0U
A
PERSONAL &AM INJURY
$ 1,000,00
GENERAL AGGREGATE
$ 2 ' 000 ' 00
GENL AGGREGATE LIMIT APPLIES PER:
PRODUCTS - COMPIOP AGO
S 2,000,00(
POLICY PJECT RO- LOC
AUTOMOBILE
LIABILITY
ANY AUTO
COMBINED SINGLE LIMIT
(Ea accident)
$
BODILY INJURY
(Per person)
S
ALL OWNED AUTOS
SCHEDULED AUTOS
BODILY INJURY
(Per amident)
$
HIRED AUTOS
NON -OWNED AUTOS
PROPERTY DAMAGE
(Per accident)
S
GARAGE LIABILITY
AUTO ONLY - EA ACCIDENT
$
OTHER THAN EA ACC
$
ANY AUTO
$
AUTO ONLY: AGG
EXCESSIUMBRELLA LIABILITY
EACH OCCURRENCE
$
OCCUR CLANS MADE
AGGREGATE
$
s
$
DEDUCTIBLE
$
RETENTION S
WORKERS COMPENSATION AND
VNC STATU- I OTH-
UL
EMPLOYERS' LIABILITY
ANY PROPRIETOR/PARTNER/EXECUTIVE
E.L. EACH ACCIDENT
$
E.L. DISEASE - EA EMPLOYE
$
OFFICER/MEMBER EXCLUDED?
Byes describe under
SPECIAL PROVISIONS below
E.L. DISEASE - POLICY LIMIT
$
OTHER
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS
he certificate holder is named as an additional insured as their interest may appear.
7.4XEa
SEA z ? .
CFRTIFICATF INnI nFR CAWCFI I ATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF, THE ISSUING INSURER HALL ENDEAVOR TO MAIL
10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,
City of Fort Collins - Building & Permits
BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY
PO Box 580
OF ANY KIND UP THE INSURER, ITS AGENTS OR REPRESENTATIVES.
Fort Collins, CO 80522-0580
AUTHORIZED R NTATIVE • ����
Rosemary9
ACORD 25 (2001108) FAX: 223-5740 V 0AC09 CORPORATION 1988