HomeMy WebLinkAboutSIGNATURE BUILDERS - INSURANCE CERTIFICATEACM CERTIFICATE OF LIABILITY INSURANCE OPID B DATE(MMIDDmY"
SIGNA-3 Ol 30 04
PRODUCER
THIS CERTIFICATE IS ISSUED AS A MATTE OF INFORMATIO
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
Hix Insurance Associates, Inc.
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
4440 Arapahoe Ave., Ste 100
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW
Boulder CO 80303
Phone: 303-444-4666 Fax: 303-444-8481
INSURERS AFFORDING COVERAGE
NAIC #
INSURED
INSURERA: United Fire 6 Casualty Co.
INSURER 8:
Signature Builders
Ron Hill DBA
1406 Fairfield Ave.
Windsor CO 80550
INSURER0
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 LMTS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
LTR
NSR
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
DATE M
POLICY EXPIRATION
DATE MMIDD/YY
LIMITS
A
GENERAL LIABILITY
X COMMERCIAL GENERAL LIABILITY
CLAIMS MADE Fx-1 OCCUR
60305942
12/07/03
12/07/04
EACH OCCURRENCE
S1,000,000
PREMISEES Toeeuronce
$100,000
MED EXP (Any one person)
$5 , 000
PERSONAL S ADV INJURY
$1 , 000 , O00
GENERAL AGGREGATE
s2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
POLICY M JPECOTT LOC
PRODUCTS - COMPIOP AGO
s2,000,000
AUTOMOBILE
LIABILITY
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON -OWNED AUTOS
COMBINED SINGLE LIMB
Me accidenq
$
BODILY INJURY
(Per Denson)
$
BODILY INJURY
(Per acoidenq
$
PROPERTY DAMAGE
(Per accident)
$
GARAGE LIABILITY
ANY AUTO
AUTO ONLY -EA ACCIDENT
$
OTHER THAN EA ACC
AUTO ONLY: AGO
$
$
EXCESSIUMBRELLA LIABILITY
OCCUR CLAIMS MADE
DEDUCTIBLE
RETENTION $
EACH OCCURRENCE
$
AGGREGATE
$
S
$
$
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY
ANY PROPRIETORIPARTNER/EXECUTIVE
OFFICER/MEMBER EXCLUDED?
M �s deacdbe under
SPECIAL PROVISIONS below
TORY LIMBS I I ER
E.L. EACH ACCDENT
$
E.L. DISEASE - EA EMPLOYE1
S
E.L. DISEASE - POLICY LIMB
1 $
OTHER
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS
Carpentry
CERTIFICATE HOLDER CANCELLATION
CITYF01 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
City of Ft. Collins IMPOSE NO OBLIGATION OR LIABIU F ANY KIND UPON THE INSURER, ITS AGENTS OR
Attn: Building Dept
BOX 580 REPRESENTATIVES.
Ft. Collins CO 80522-0580 AUTHORIZED REPRESENTATIVE