HomeMy WebLinkAboutCOTTONWOOD DRYWALL - INSURANCE CERTIFICATE (2)ACORD,a CERTIFICATE OF
LIABILITY INSURANCE
DATE(M
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/
PRODUCER
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Flood & Peterson Insurance Inc
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
4821 Wheaton Drive
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
P O Box 270370
Fort Collins, CO 80527
INSURERS AFFORDING COVERAGE
NAIC #
INSURED
INSURERA: PlnnaCOI Assurance
Cottonwood Drywall Inc.
C/O The Employer Source
INSURER B:
3780 East 15th Street Ste 201
INSURER C:
Loveland, CO 80538
INSURER D:
INSURER E:
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.
LTR
INSR
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
DATE (MMIDDIYYI
POLICY EXPIRATION
DATE
LIMITS
GENERAL LIABILITY
EACH OCCURRENCE
$
COMMERCIAL GENERAL LIABILITY
DAMAGE TO RENTPREMISES tE"mED
$
MED EXP (Any one person)
$
CLAIMS MADE OCCUR
PERSONAL B ADV INJURY
$
GENERAL AGGREGATE
$
GEN'L AGGREGATE LIMIT APPLIES PER:
PRODUCTS-COMP/OP AGG
$
17 POLICY JEPROCT LOG
AUTOMOBILE
LIABILITY
ANY AUTO
-
COMBINED SINGLE LIMIT
(Ee accident)
$
BODILY INJURY
(Per person)
$
ALL OWNED AUTOS
SCHEDULED AUTOS
BODILY INJURY
(Per accident)
$
HIRED AUTOS
NON -OWNED AUTOS
PROPERTY DAMAGE
(Per accident)
$
GARAGE LIABILITY
AUTO ONLY - EA ACCIDENT
$
OTHER THAN EA ACC
$
ANY AUTO
0
$
AUTO ONLY: AGG
EXCESS/UMBRELLA LIABILITY
EACH OCCURRENCE
$
AGGREGATE
$
OCCUR CLAIMS MADE
DEDUCTIBLE
$
RETENTION $
A
WORKERS COMPENSATION AND
4066596
03/01/05
03/01/06
X WC STATU- OTH-
EEL
EMPLOYERS' LIABILITY
E.L. EACH ACCIDENT
$500000
ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICER/MEMBER EXCLUDED?
If yes, describe under -
E.L. DISEASE - FA EMPLOYEEI
$500000
E.L. DISEASE - POLICY LIMIT
$500000
SPECIAL PROVISIONS below
OTHER
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS
City of Fort Collins
Contractor Licensing
Attn: Jan/Purchasing
PO Box 580
Fort Collins, CO 80522
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL A0_ DAYS WRITTEN
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
AUTHORIZED REPRESENTATIVE
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