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HomeMy WebLinkAboutDIVERSIFIED SPECIALTIES - INSURANCE CERTIFICATEACORD. CERTIFICATE OF LIABILITY INSURANCE 06/20/20 6 PRODUCER (303)980-0220 FAX (303)980-1610 THE BURGESS AGENCY, INC. 9100 WEST JEWELL AVE #100 P.O. BOX 150037 LAKEWOOD, CO 80215-0037 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 BELOW. INSURERS AFFORDING COVERAGE NAIC # INSURED Diversified Specialties of Colorado dba Basements & Beyond 1361 Hilltop Drive Windsor, CO 80550 INSURERA: Wellington Specialty Ins Co INSURERS: Pinnacol Assurance 41190 INSURER C: INSURER D: INSURER E: rnVFRAT:FS 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 kDD'L TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE (Milli POLICY EXPIRATION LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS MADE FX OCCUR OS00200340 05/13/2006 -DA741111111111111030- O5/13/2007 EACH OCCURRENCE $ 1,000,00 DAMAGE TO RENTED $ 1000000 MED EXP (Any one person) $ 5 , OO PERSONAL & ADV INJURY $ 1,000,00( GENERAL AGGREGATE $ 2,000,00( GEN'L AGGREGATE LIMIT APPLIES PER: X POLICY PROJECT LOC PRODUCTS - COMP/OP AGG $ 2,000,00( AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY ANY AUTO AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC AUTO ONLY: AGG $ $ EXCESSIUMBRELLA LIABILITY OCCUR CLAIMS MADE DEDUCTIBLE RETENTION $ EACH OCCURRENCE $ AGGREGATE $ $ $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITYEL ANY PROPRIETORTORIPAR NE PARTNER/EXECUT OFFICER/MEMBER EXCLUDED? H yee, describe under SPECIAL PROVISIONS below 4057901 05/01/2006 05/01/2007 X I WC STATU- OTH- .. EACH ACCIDENT $ 10O oO r E.L. DISEASE - EA EMPLOYEE $ 100,000 E.L. DISEASE - POLICY LIMB OTHER DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS City of Ft. Collins PO BOX 580 Ft. Collins, CO 80522 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LUIBILITY ANY KIND UPON THE AUTHORIZED REPRESENTATIVE JD ACORD 25 (2001108) FAX: (970)ZZ4-6134 ©ACORD CORPORATION 1988 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. ACORD 25 (2001108)