HomeMy WebLinkAboutSUPERIOR ROOFING - INSURANCE CERTIFICATEDATE
ACIORD,, CERTIFICATE OF LIABILITY INSURANCE 04123108Dm)
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Van Gilder Insurance Corp. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
700 Broadway, Suite 1000 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
Denver, CO 60203 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
303 837.8500 INSURERS AFFORDING COVERAGE
Superior Roofing, Inc.
14700 East39th Avenue
Aurora, CO 80011
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR TI'IE 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 TI'IE 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 POLICY IMFFECTIVE POLICY EXPIRATION
LTR TYPE OF INSURANCE _ POLICYNUMBER DATE MMIDOIYY),„D@TE (M1IMIDD/Y�I LIMITS
A
GENERAL LIABILITY
2071256465
05/01/08
05/01/09
EACH OCCURRENCE
$1000060
_
x xIG-OMM LRCIAL GENERALI IABIL ITY
DAMAGE (Ally 0Do life)
$300000
1CLAIMSMAOE [k)OCCUR
_FIRE
HEDEXP(Anyoneperso11 n)
$10000
PERSONAL &ADV INJURY
$1,000,000
_. ____ ......
GENERAL AGGREGA I E
52,090000
GENL AGGREGATE LIMIT APPL IES PER;
PRODUCTS C_O.MPIOPAGG2,
000 0
POLICY I.X —LOC
...... _..
A
AUTOMOBILE
LIABILITY
2071256479
05/01/08
05/01/09
X
ANYAUro
COMBINED SINGLE LIMIT
(Fa aaideml
$1,000,000
- .,,.
ALL OWNED AUTOS
BODILY INJURY
SCHEOUi.EO
ire,pAUTOS (Pet person)
$
X
HIRED AUTOS
- -
BODILY INJURY
X
NON-UWNEU AUTOS
(Pet acclVenl)
--------.
PROPERTY DMdAGF.
$
(Per acci0onl)
GARAGE UABILHY
AUTO ONLY, EA ACCIDENT
$
.$_. _..__...
ANY AUTU
EAACC
OTHER THAN ....._.
__.. _....
_
AUTOONLY: AGG
$
B
EXCESS LIABILITY
BE3528972
05/01/08
05/01/09
EACH OCCURRENCE
$5 000 000
X OCCUR _.ICLAIMSMADE
AGGRFGATF
$5,000 ODO
......
._._ __...s—
5 ._..__..
DEDUCTIBLE
I
_..
X RETENTION S10,000
A
WORKERS COMPENSATION AND
2071256482 4
05101/08 '
05/01/09
x WC 87AT0- OTI I
I ORY LIMITS.
EMPLOYERS' LIABILITY
.. ..._.._ _ER.
E"L.,EACIi ACCIDENT'
............... ...._..__..—_....._.
51,000,000
EL DISEASE EAEMFLOYFE,$�-OOO
OOO
B1. DISEASE - POLICY LIMIT,
$1,000,000
OTHER
DESCRIPTION OF OPERATIONSILOCATIONSNEHICLESIEXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
RE: Ft Collins Utilities
(See Attached Descriptions)
City of Ft. Collins, Purchasing
PO Box 580
Fort Collins, CO 80522
ACORD 25-S 17/97)1 of 3 #M5302m
SHOULD ANY OF THE ABOVE D ESCRBED POLICIES BE CANCELLED REFORF THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30. __. DAYS WRITTEN
NOTICE TOTHE CERTIFICATE HOLDER NAM ED TOTH E LEFT, BUT FAILU RE TO DO SO SHALL
IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR
A'� ORIZED REFIRE
Xl T 0 ACORD CORPORATION 4QRP
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).
�Y�1LriL�
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.
AUUKU ZbS t11902 or 3 IfM530260
DESCRIPTIONS (Continued from Page 1)
As required by written contract or written agreement, the City of Ft. Collins is included as Additional Insured for ongoing
operations under General Liability.
AMS 25.3 (07197) 3 of 3 SM530260