HomeMy WebLinkAboutSCHROEDER ROOFING CO - INSURANCE CERTIFICATEACORD. CERTIFICATE
OF LIABILITY INSURANCE
° 05/26 004
PRODUCER
Serial # A3485
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
COLORADO WORKERS'
COMPENSATION NETWORK, INC.
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
6635 S. DAYTON ST, SUITE 240
GREENWOOD VILLAGE CO 80111
INSURERS AFFORDING COVERAGE
NAIC#
INSURED
INSURER A: PINNACOL ASSURANCE
SCHROEDER ROOFING CO.
INSURER B:
1300 NORTH MONROE AVENUE
INSURER C:
LOVELAND CO 80537
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 POLICES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH
POLICIES, AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
MTR
N RL
TYPE OF INSURANCE
POLICY NUMBER
POg7E EF /LID I YE
EXPIRATION
X (RATION
POLIDATCY
LIMITS
GENERAL LIABILITY
EACH OCCURRENCE
§
COMMERCIAL GENERAL LIABILITY
CLAIMS MADE OCCUR
DAMAGE TO
a NTEDPREMISES CUnence,
$
MED EXP (Any oneperson)
§
PERSONAL &ADV INJURY
S
GENERAL AGGREGATE
$
GEN'L AGGREGATE LIMIT APPLIES PER:
PRODUCTS - COMP/OP AGG
§
POLICY ,PE i
JECLOC
AUTOMOBILE
LIABILITY
ANY AUTO
COMBINED SINGLE LIMIT
(Ea accident)
$
BODILY INJURY
(Per person)
§
ALL OWNED AUTOS
SCHEDULED AUTOS
BODILY INJURY
(Per accident)
9
HIRED AUTOS
NON -OWNED AUTOS
PROPER (DAMAGE
(Per aocidera)
§
GARAGE LIABILITY
AUTO ONLY - EA ACCIDENT
$
OTHER THAN EA ACC
$
ANY AUTO
S
AUTO ONLY: AGG
EXCESSA)MBRELLA LIABILITY
EACH OCCURRENCE
§
OCCUR CLAIMS MADE
AGGREGATE
$
i
§
DEDUCTIBLE
§
RETENTION S
WORKER'S COMPENSATION AND
4030163
06/01/04
06/01/05
CC gg
X W Ry LIN11iU � � R
A
EMPLOYERS' LIABILITY
ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICERIMEMBER EXCLUDED?
EL EACH ACCIDENT
S 500,000
EL DISEASE - EA EMPLOYEE
S 500,000
If yes, describe under
SPECIAL PROVISIONS below
EL DISEASE - POLICY LIMIT
S 500,000
OTHER
DESCRIPTION OF OPERATtONSILOCATK)NSIVEHICLESIEXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS
CERTIFICATE HOLDER
CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN
CITY OF FORT COLLINS
PO BOX 580
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
FORT COLLINS CO 80522
IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
REPRESENTATIVES.
AUTHORIZED REPRESENTATIVE SOEHNGEN
'THHOMAS
•
ACORD 25 (2001108) W AUVKU L:vKrU1<AI I WIN I V00