HomeMy WebLinkAboutCAMPANA CONSTRUCTION - INSURANCE CERTIFICATE (2)02/28/2005 02:16 9702235740 BELLISIMO INC PAGE 03
ACOM CERTIFICATE OF LIABILITY INSURANCE 09/2 /20o
PRODUCER (970)223-0924 FAX (970) 267-2231 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Community First Insurance, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
1075 W Horsetooth Rd, Ste 100 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Fort Collins, CO 90526
INSURERS AFFORDING COVERAGE _ _ NAIL #
NsuRED Campana Construction Corp INSURERA: Colorado Casualty Insurance 41785
2020 Lowe, Ste 201 INSURERS:
Fort Collins, CO 90526 INSURER C:
INSURER D:
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDIN(
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 7HE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCK
POLICIES.AGGREGATE LIWTS.SHOWN MAYJiAVE BEEN REDUCED BY PAID CLAIMS, • - - - -- - -- - - - - -
NSR
D'
TYPE OF INSURANCE
POLICY NUMBER
POUCYEFPECTIVE
POUCYEIPIRATON
UMRS
A
GENERAL UABIJTY
X COMMERCIALGENEPALLIASILITY
CLAIMS MADE O OCCUR
AP053987803
09/22/2004
09/22/2005
EACH OCCURRENCE
$ 1,00000
ETORENTED
f 500100
MED EXP (Any wm penal)
S 5 O0
PERSONAL & AOV INJURY
S 1, 000 , O
GENERAL AGGREGATE
S 2,000 O
GENL AGGREGATE LRIIMpIIT. APPLIES PER
POLICY JECi LOC
PRODUCTS . COMPIOP AGO,
S 2,000,00(
AUTOMOBILE
LIAEIUTY
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON-ONNEDAUTOS
COMBINED SINGLE LIMIT
(Es ualbn)
S
BODILY INJURY
(Per pen)
ne
$
BODILY INJURY
(per swden)
S
PROPERTY DAMAGE
(Poro¢ciderd)
S
OARAGE LIABILITY
ANY AUTO
AUTO ONLY -EA ACCIDENT
3
OTHER THAN EAACC
AVroONLY: AGG
S
EXCEW""RE" A LIABRITY
OCCUR �CLAIMS MADE
DEDUCTIBLE
RETENTION S
EACH OCCURRENCE
i
AGGREGATE
S
S
$
WORKERS COMPENSATION AND
EMPLOYFRV UABIUTY
ANY PROPRIETORIPARTNER MCLITIVE
OyFaaFIICEWMEMBER EXCLUDED1
$PECIA PROVISIONS aescrin 0 pebw
YJC 6TA - O N-
E.L. EACH ACCIDENT
$
&L. DISEASE -EA EMPLOY
S
E.L. DISEASE • POLICY LIMIT
S
OTHER
DESCRIPTION OF OPERATIONS/ LOCATIONSIVENI /EXCLUSIONS ADDEB BY ENDORSEMENT SPECIALPROVISIONS
he certificate holder is na� as an additional insured as their interest may appear.
FAXED
SEP 21 2004
rTC07TEIn KTG UAI nco P•AM&INI I ATInU
SHOULD ANY OFTHE ADONE DESCRD3ED POLICIES BE CANCELLED WPM THE
EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL
3.0 DAYS WRITTEN NOTOE TOTNE CERTIRCATE HOLDER NAMED TO THE LEFT,
city of FortCollins.- Building & Permits
BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY
PO BOX S8O - - - -
DF ARY KING U E INSURER ITS AG R REPRESENTATIVES.
Fort Collins, CD 80522-0580
AUTHORIZED RE ATIVE +
Rosemary
ACORD 25 (200TJ08) rAA; ccs-!bf'tu V 0AC005 CORPORATION 1988