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HomeMy WebLinkAbout124317 ADVANCED ROOFING TECHNOLGIES - INSURANCE CERTIFICATE (2)A ORL CERTIFICATE OF LIABILITY INSURANCE DATE/VY) M /06 03/10/06 PRODUCER 1-303-534-4567 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION The INA Financial Group, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE IMA of Colorado, Inc. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 1550 17th Street ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Suite 600 Denver, CO 80202 INSURERS AFFORDING COVERAGE INSURED Advanced Roofing Technologies Ltd., Inc. INSURER A: Pinnacol Assurance INSURER B: c/o Resource Management Systems, Inc. 7447 East Berry Avenue, Suite 200 INSURER C: Greenwood Village, CO 80111 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. INSR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE (MM/nD1YY) POLICY EXPIRATIONDATE DATE iMMfDn" LIMITS GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY CLAIMS MADE1:1 OCCUR EACH OCCURRENCE $ FIRE DAMAGE (Arty one fire) $ MED EXP (Any one erwn) $ PERSONAL 8 ADV INJURY $ GENERALAGGREGATE $ GEWL AGGREGATE LIMIT APPLIES PER: PRO LOC POLICY JIMCIT PRODUCTS-COMP/OPAGG $ AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (ParPer�) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY ANY AUTO AUTO ONLY - RA ACCIDENT $ OTHER THAN EA ACC AUTO ONLY: AGG $ $ EXCESS LIABILITY OCCUR CLAIMS MADE DEDUCTIBLE RETENTION $ EACH OCCURRENCE $ AGGREGATE $ $ $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY 4098470 01/01/06 01/01/07 TH- X WC LIMIT ER E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYE $ 1, 000, 0D0 E.L. DISEASE -POLICY LIMIT $1, 000, 000 OTHER 9 S S DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS CFRTIFICATF_ HOLDFR I I ennrnnuer IR411RFn• INRIIYFR I FTTFa- CANCFI LOTION Pro]ect. Beattie Restroom Roof SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION City Of Ft Collins - CLRS Parke Division 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 413 S Bryan Ave IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVEI(�Z1 Fort Collins, CO 80521 USA ^b ACORD 25-S (7/97) lcaillet m ACORD CORPORATION 1988 4059133 Powered ByCertificatesNowTM IMPORTANT If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). DISCLAIMER The Certificate of Insurance on the reverse side of this form does not constitute a contract between the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon. AGE)HU 25-5 (7197) A DM. CERTIFICATE OF LIABILITY INSURANCE 3 12006 n PRODUCER Phone: 970 224-5205 Fax: 970 224-4283 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Ed Murray & Sons 425 West Mulberry Suite 205 ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Fort Collins CO 80521 INSURERS AFFORDING COVERAGE NAIL# INSURED INSURERA: Continental Western Insurance 10804 Advanced Roofing Technologies, LTD Brad Evans 2004 Heath Parkway, Unit B INSURER B: INSURER C: INSURER D. Fort Collins CO 80524 INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW RAVE 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. IRANCF POUCYNUMSER POLICYEFFECNVE POUCYEXPI nom LIMITS A X GENERALLIABILITY CGL2613566-10 3/4/2006 3/4/2007 EACHOCCURRENGE $ 1, 000, 000 X COMMERCIAL GENERAL LIABILITY PREMISES Eaommenm $ 100,000 CLAIMS MADE I OCCUR MEDEXP(Aryore neon) $ 5,000 PERSONAL A ADV IWURY $ 1, 000, 000 GENERALAGGREGATE $ 2, 000, 000 GENL AGGREGATE LIMIT APPLIE S PER: PRODUCTS -COUROPAGO $ 2, 000, 000 X I POLICY I I P LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ ANYAUTO (EascdderC) BODILVINJURV $ ALLOWNEDAUTOS SCHEDULEDAUTOS (Per Pereon) BODILYINJURY $ HIREDAUTOS NONOWNEDAUTOS (Peraccidarq PROPERTYIIAMAGE $ (Pasocklerq GARAGEUABIUTY AUTO ONLY -EA ACCIDENT $ OTHERTHAN EAACC $ ANYAUTO $ AUTOONLY: AGG EXCES&UMBRELLA UABILITY EAC14OCCURRENCE $ OCCUR CLAIMSMADE AGGREGATE $ $ $ DEDUCTIBLE $ RETENTION f WORKERS COMPENSATION AND WCS AlU- OTH- EMPLOYERS'LIASILITY ANYPRDPRIETONPARINERA:XECURVE E.L. EACHACCIDENT S E.L. DISEASE -EA EMPLOYEE $ OFFICERIMEMSER EXCLUDED? Ityaa demrlbsunder SPECIAL PROVISIONS below EL DISEASE - POLICY LIMIT $ A eased CNP2613568-10 3/4/2006 3/4/2007 9100,000 $500 deductible Equipment DESCRIPTION OF OPERATIONS, LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS Roofing Contractor Certificate Holder is Named as Additional Insured to include Waiver of Subrogation on the listed policy when required by written contract as per listed endorsements added to the General Liability Policy: CG2404 10/93 - Blanket Waiver of Transfer of Rights; CG2031 07/04 & CG2010 07/04 - Blanket Additional Insured Project: Beattie Restroom Roof CERTIFICATE MOLnFR CAMCCI I ATN1M 'in SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED City Fort Collins BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER l' Of WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CLRS-Parks Division CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO 413 S. Bryan Ave. SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON Fort Collins CO 80521 THE INSURER, ITS AGENTS OR REPRESENTATIVES. AU HORREDREPRESENTATIVE ACORD 2S (2001/00) ©ACORD CORPORATION IM IMPORTANT If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement on this certificate does not confer rights to the certificate holder In lieu of such endorsement(s). If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). DISCLAIMER The Certificate of Insurance on the reverse side of this form does not constitute a contract between the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend, extend or aiter the coverage afforded by the policies listed thereon. POLICY NUMBER: COMMERCIAL GENERAL LIABILITY CO 24 04 t0 93 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ R CAWU.LY. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name of Person or Organization: BLANKET - WHERE REQUIRED BY WRITTEN CONTRACT If oa�or s appear above, bo cable to des endorsement.)�irrequiirto complete this endorsement will be shown in the The TRANSFER OF RIGHM OF RECOVERY AGAINST OTFERS TO US Condition (Section Iv - COM- NIERCIAL GENERAL LIABILITY CONDITIONS) is amended by the addition of the following: We waive any right of recovery we may have against the person or organization shown in the Schedule above because of payments we make for . injury or damage arising out of your ongoing operghons or your work done under a contract wth that person or ` organization and inductedin 3r In -Sc I�ted oopg ations hazard". This waiver applies only to tperson or organization the CO 24 04 V 93 Copyright, Insurance Services Office, Inc, 1992 O COMMERCIAL GENERAL LIASIUiY CG 20 33 07.04 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - AUTOMATIC STATUS WHEN REQUIRED IN CONSTRUCTION AGREEMENT WITH YOU This endorsement, modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART A. Section Il — Who Is An Insured is amended to include as an additional insured any person or or gan'rze ion for whom you are performing operations when you and such person or organization have agreed in writing in a contract Or agreement that such person of organization be added as an addi- tional insured on your policy. Such person or or- ganization Is an additional Insured only with re- spect to liability for "bodily. injury", "property damage" or "personal and advertising injury' mused, in Whole or in part, by: 1. Your acts or omissions; or 2. The acts or omissions of those: acting on your behalf; in the performance of your :ongoing operations for the additional insured. A person's.:or organizatian's status as an additional insured under this endorsement ends when your operations for that additional insured are com- pleted. B. With respect to the insurance afforded to these additional insureds, the following additional exclu- sions apply: This Insurance does not apply to:_ 1. "Bodily injury", "property damage" or "personal and advertising injury" arising out of the render- ing of, or the failure to :render, any professional architectural, engineering or surveying ser- vices, including: a. The preparing, approving, or failing to pre= pare or approve, maps, shop drawings, opinions, reports, surveys, field orders. change orders or drawings and specifica- tions; or b. Supervisory, Inspection, architectural or engineering activities. 2. 'Bodily injury" or "property damage" occurring after: a. Alt work, including materials, parts or equipment furnished in connection with such work, on the project (other than ser- vice, maintenance or repairs) to be per- formed by or on behalf of the additional in- sured(s) at the location of the covered operations has been completed; or b. That portion of "your work" out of which the injury or damage: arises has been pot to. Its intended use by any person or organization other than another contractor or subcontrac- tor engaged in performing operations for a principal as a part of the same project. CG 20 33 07 04 @ (SO Properties. Inc.. 2004 Page i of 1 0