HomeMy WebLinkAbout291984 4-K PAINTNG AND DRYWALL INC - INSURANCE CERTIFICATECERTIFICATE OFIfLIABILITY IN�SURANCEFGb 11 zoos oe
-0924 FAX (970)267-2231 I THIS CERTWICATP IA LQ41IP11 ea A LEA ED
Colorado BW dnSUrance Agency, Inc
107S W Rorsotooth Rd Ste 106
Fort Collins CO 80526
Z900 Galway
Laporte CO 80535
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INSURERS AFFORDING COVERAGE
RN URERA Continental Wastern
IN6Q0ERB PTnnacol Assurance
INSURER E
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POO 402
DATE(MpDDDYTTY)
NAK. #
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THEINSURED NAME3A6ObE FOR THE POLICY PERIOD INDICATED NOTIMTHSTANDIN6
ANY REQUIREMENT TERM OR CONDITION OF ANY CONTRA+Y OR OTHER DOCUMENT Milk RESPECT TO WH CH THIS CERTIFICATE MAY BE ISSUED OR
MAYPERTAIN THE INSURANCE AFFORDED BY THE POLIC ES VESCI31SED HEREIN IS SJBJEDT TO ALL THE TERMS EXCLUSIONS AND CONDITIONS OF SUCH
POLICES AGGREGATE IMIT& &NOWT MAY HAVE BEEN REDUCED BY PAD C,AIMS
INBR
DD'
TYPEOFINSURANce
POLICY NUMSBR
rPOLICY
EXPI A DAM Muffiphsl
LIM TS
A
GENERAL-NOILITY
X COMMFACNL GENERA UUNLITY
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C.AIMA MADE LJ OCCUR
CNP2706LSSZJ
07 2312007
07/23/200$
uCNxcumENCE
7 1 000 e 00(
RENTED
S 250 0O
IVIED EXP (AM one m eol)
S AP
PEPSONAL & AOV INJURY
$ 1,000 00
GkAERALAGGREGATE
6 2 000 0O
GEML �..OREGATS LIMq APFUEB PER
T POLICY 7 JECT LOC
PRODUCTS pOMP/OPAOG
4 2 000 0
AUTOMORLE
LIASILTY
ANd AUTO
ALL ONMEDAUTOS
SCHEDULED AUTO°
HREDAUTp6
NON OWNED ALR09
COMBINED SINGLE L UIT
(Ee eeoNe )
Bp0 YINA.RY
BOD Y IMI
$
BOOILYINA
(P Pmneni)
S
FROPEPTY DAMAGE
(Per eW wt
6
OARPOE LIAMLRY
ANY AUTO
AUTO ONLY EA 4CCIDEM
$
OTHER -NAIL EA ACC
AUTO ONLY AGO
5
6
I
I
lXCRSSNtlERCLLA LUL8ILITY
OCCUR CLAIMS UADC
DEDUCTIBLE
RCTENTION $
EACH OCCURRENCE
S
AGOR.ECATE
$
S
S
I
B
WORKERS COMPCNSA-ION AND
EMPLOYERS LIABILITY
0Wr PROPRIETORIPARTNERrEXECU-I!E
FFICERIMEMB RG GLUDED
U Yec ieo w Iy y�
APCCIq PROVISIONS bebv
Gmu
4080430
07/01/2007 07 01/2008
EL EACH ACCIDCN-
S 100
E L O16EASE EA EMPLOYE
S 100.00(
EL DISEASE POLICY LIMIT $ 500
OWCPoPTON OF pPERATKJNBILOCATIONS ✓ENICLES I EXCLUSIONS ADDED BYENDOPSENENT SPECIAL PROVBPON$
City of Fort Collins
PO Box 580
Fort Collins CO 90522
ACORD 26 (20011m) FAX
SWUM ANYOFTHEABCYE MI POLKSE$ SECANCm I EUBEFORETHE
EXPIRATION DAIS THEREOF THE ISSUNG INSURER WILLENDEAVORTO MA1L
10 UAYSWRRTENNOT'CETOTKECERTIF+CATEHOLD R&MEOTOTNRHEFT
BUT All TO MAL SUON NOTICE SMALL IMPOSE NOOBLIUATION ORLUVSUTY
:Y.cr•:a--..
COI nFnnG-RW INSIIRnNCF F,v ta,n.a. ni c.e 1n onrm (" — onn. mrn
IMPORTANT
If the certifrate holder Is an ADDITIONAL INSURED the pollcy(les) must be endorsed A statement
on this certificate does not confer fights to the certificate holder in lieu of such endorsemant(s)
If SUBROGATION IS WAIVED subject to the terms and conditions of }he policy, certain policies may
equire an endorsement A statement on tors cortificate does not rwfar rights to the certifcate
holder In lieu of such andorsement(s)
DISCLAIMER
The Cartifloate of Insurance on the reverse side of this form does not constitute a contract between
the issuing msurar(s) airthorized representative or producer and the certificate holder nor does It
affirmatively or negatively amena extend or after the coverage afforded by the pollcias listed thereon