HomeMy WebLinkAboutA H ROOFING - INSURANCE CERTIFICATECERTIFICATE OF LIABILITY INSURANCE
American Family Insurance Company ❑
American Family Mutual Insurance Company if selection box is not checked.
6000 American Pky Madison, Wisconsin 53783-0001
Insured's Name and Address Agent's Name, Address and Phone Number (Agt./Dist.)
A & H Roofing Daniel A Bott (303) 452-6465
837 S Kunner Rd 234 12000 N Washington St Ste 230
Brighton, CO 80601-2857 Thornton, CO 80241 (1371304)
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 listed below.
COVERAGES
This is to certify that 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 centficate may be issued or may pertain, the insurance afforded by the policies described herein is subject to an the terms, exclusions, and conditions of such policiesOLICY
TYPE OF INSURANCE
POLICY NUMBER
DATE
LIMITS OF LIABILITY
EFFECTIVE EXPIRATION
Mo Day, Yr(Mo. Day,Yr
Homeowners/
Badly Injury and Property Damage
Mobilehomeowners Liability
Each Occurrence $ ,000
BoatowOera Liability
Bodily Injury and Property Damage
Each Occurrence $ '000
Personal Umbrella Liability
Botlily Injury and Property Damage
Each Occurrence $ ,000
Fan Liability & Personal Liability
Farm/Ranch Liability
Each Occurrence $ 000
Farm Employers Liability
Each Occurrence $ 000
Workers Compensation and
Statutory .*,.:....,,.
Each accident $ 1000
Employers Liability t
Disease - Each Employee $ '000
Disease - Policy Limit $ ,000
General Liability
General Aggregate $ 2,000 000
Products -Com leted Operations Aggregate $ 2,000 ,000
® Commercial General
Liability (occurrence)
❑
05-XA7071-03-00
11 /25/2005
11 /25/2006
Personal and Advertising Injury$ 1,000 .000
Each Occurrence $ 1,000 ,000
❑.
Damage to Premises Rented to You $ 100 000
Medical Expense (Any One Person) $ 5 000
Businessowners Liability
Each Occurrencet t $ '000
Aggregatett $ ,000
Liquor Liability
Common Cause Limit $ '000
Aggregate Limit $ '000
Automobile Liability
BodilyInjury - EachPerson $ '000
❑ Any Auto
❑ All Owned Autos
Bodily Injury - Each Accident $ '000
❑ Scheduled Autos
$
❑ Hired Auto
Property Damage 000
❑ Nonowned Autos
(]
Bodily Injury and Property Damage Combined $ ,000
Excess Liability
❑ Commercial Blanket Excess
»W � � � �
Each occumence/aggregate $ ,000
71
Other (Miscellaneous Coveraaes)
DESCRIPTION OF OPERATIONS i LOCATIONS / VEHICLES / RESTRICTIONS i SPECIAL ITEMS t The individual or partners shown as Insured ❑ Have ❑ Have not
City of Ft Collins is listed as Certificate Holder elected to be covered as employees under this policy.
tt Products -Completed Operations aggregate is equal to each
occurrence limit and is included in policy aggregate.
CERTIFICATE H04DEWS NAME AND ADDRESS
CANCELLATION
• City of for[ Collins
Y
LJ Should any of the above described policies be cancelled before the
expiration date thereof, the company will endeavor to mail'( days)
281 N College Avenue
written notice to the Certificate Holder named, but failure to mail such
P O Box 580
notice shall impose no obligation or liability of any kind upon the
co any, its a nts or representatives. *10 days different
Ft Collins CO 80522
unless
numgSer of days Own.
® This certifies coverage on the date of issue only. The above
described policies are subject to ca ellation in conf ormity with their
terms and by the laws oft to of is e.
FAX: 1-970-224-6134
DA E Is UED
AUTHO IZ RE RESENTATI
E
01/03/2006
r- l
U-201 Ed. 5100 Certificate Holder St. No. 6666 Rev. 7/02