HomeMy WebLinkAboutNORMANDIN CONSTRUCTION - INSURANCE CERTIFICATEs� CERTIFICATE OF LIABILITY INSURANCE
A,C ORl DATE (MMIDD/YYYY)
1 04/01 /2008
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Brooke Insurance ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
2108 Milestone Drive, Suite 200 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Fort Collins, CO 80525
INSURERS AFFORDING COVERAGE NAIC #
INSURED INSURERAColony Insurance Company
Normandin Construction, Inc. INSURERS: The Hartford
1903 Silvergate Road INSURER C: Pinnacol Assurance
Fort Collins, CO 80526 INSURER D:
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.
LTR
INSRD
TYPE OF INSURANCE
POLICY NUMBER
DATE MMID NV
A E MMI
LIMITS
A
GENERAL LIABILITY
✓ COMMERCIAL GENERAL LIABILITY
CLAIMS MADE R] OCCUR
GL154311
04/01/2008
04/01/2009
FACHOCCURRENCE
$ 1,000,000
DAMAGE TO RENTED
PREMISES Ea occurence
$ 100,000
MED EXP (Any one person)
$ 5,000
PERSONAL &ADV INJURY
$ 1.000,000
GENERAL AGGREGATE
$ 2,000,000
GENT AGGREGATE LIMIT' APPLIES PER:
✓ POLICY PROJECr LOC
PRODUCTS-COMP/OP AGG
$ 2,000,000
B
AUTOMOBILE LIABILITY
ANY AUTO
✓ ALL OWNED AUTOS
SCHEDULED AUTOS
HIREDAUTOS
NON -OWNED AUTOS
34 UECN02023
04/01/2008
04/01/2009
COMBINED SINGLE LIMIT
(Ea accident)
$ 1.000,000
BODILY INJURY
(Per person)
$
BODILY INJURY
(Per accident)
$
PROPERTY DAMAGE
(Peracciden0
$
GARAGE LIABILITY
ANYAUTO
AUTO ONLY - EAACCIDENT
$
OTHER THAN EA ACC
AUTO ONLY: AGG
$
$
EXCESS/UMBRELLA LIABILITY
OCCUR CLAIMSMADE
DEDUCTIBLE
RETENTION $
EACH OCCURRENCE
$
AGGREGATE
$
5
$
$
C
WORKERS COMPENSATION AN[
EMPLOYERS' LIABILITY
ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICER/MEMBER EXCLUDED?
If Yea, describe under
SPECIAL PROVISIONS below
4097258
11/01/2007
11/01/2008
✓ TORY LIMITS ER
E.L. EACH ACCIDENT
$ 100,000
L.L. DISFASEPA I]dPLOYE[
$ 100,000
E.L. DISEASE - POLICY LIMIT
$ 500,000
OTHER
DE5CRIPI ION OF OFLIRAJ IONS I LOUA I IONS I Vhfll�LhS I EXCLUSIONS ADDED BY 17ROM I!MffRTT9P9CWM )VISIONS
tQd:Lltlr\i•\ii:bl Ulti: Ne\: rNtl�GU UI:
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATIO
City
of Fort Collins
30
P.O.
Box 580
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL DAYS WRITTEN
—
Fort
Collins, CO 80522
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
REPRESENTATIVE
AUTHORIZED REPRES T
ACORD 25 (2001108) / � (
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.