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Home My WebLink AboutROBERT SMITH CONSTRUCTION - INSURANCE CERTIFICATEClient# 40726 ROBSM ACORD.a CERTIFICATE OF LIABILITY INSURANCE 06104/oe°�"" PRODUCER Flood & Peterson Insurance Inc 4821 Wheaton Drive 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 P O Box 270370 Fort Collins CO 80527 INSURERS AFFORDING COVERAGE NAIC # INSURED Robert Smith Construction Inc PO Box 272969 Fort Collins CO 805271714 INSURERA PRnnacolAssurance I INSURER INSURER C INSURER 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 LTR M.02 TYPE OF INSURANCE POLICY NUMBER ATPOLICY EFFECTIVE POLICY EXPIRATION LIMITS GENERAL LIABILITY EACH OCCURRENCE $ DAMAGE TORE TIED $ COMMERCIAL GENERAL LIABILITY CLAIMS MADE 0 OCCUR MED EXP (Any we person) $ PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ GEN L AGGREGATE LIMIT APPLIES PER PRODUCTS COMP/OPAGG $ POLICY 7 PRO LOC AUTOMOBILE LIABILITY ANY AUTO COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) $ ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY (Per ecoldent) $ HIRED AUTOS NON OWNED AUTOS PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY AUTOONLY EAACCIDENT $ OTHER THAN EA ACC $ ANY AUTO S AUTO ONLY AGG EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR CLAIMS MADE AGGREGATE $ E $ DEDUCTIBLE $ RETENTION $ A WORKERS COMPENSATION AND 4059660 07/01/08 07I01I09 X WC STATU OTH �V LIMITS EMPLOYERS LIABILITY ANY PROPRIETORLPARTNERIFXECUTIVE E L EACH ACCIDENT $1 OO OOO EL DISEASE EA EMPLOYEE $100000 OFFICEWMEMBER EXCLUDED? Byes describe under SPECIAL PROVISIONS below E L DISEASE POLICY LIMIT $500000 OTHER DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT/ SPECIAL PROVISIONS Attn Sandy Lindell City of Fort Collins P O Box 580 Fort Collins CO 80522 I ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION iEREOF THE ISSUING INSURER WILL ENDEAVOR TO MAIL All DAYS WRITTEN TO THE CERTIFICATE HOLDER NAMED TO THE LEFT BUT FAILURE TO DO SO SMALL NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER ITS AGENTS OR ACORD 25 (2001108) 1 s 9 1fQA179AA/IUTA479n5 F/OocR 'r a TNC ❑si Lei 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 2" (2001108) 2 of 2 #S417206/M417205