HomeMy WebLinkAboutSUNRISE PLUMBING COMPANY - INSURANCE CERTIFICATEClient*- 111(171
ctncl IKIPIC9:9
ACORU., CERTIFICATE OF LIABILITY
-----------
INSURANCE
DATE fMMIDDIYYYY)
06/23/08
PRODUCER
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
HUB SW Denver CL
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
1801 Broadway, Suite 820
Denver, CO 80202
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
303 297-1225
INSURERS AFFORDING COVERAGE
NAIC #
INSURED
Sunrise Plumbing Company, Inc.
13092 Kearney Street
Thornton, CO 80602
INSURERA: Mountain States Mutual Casualty Comp
INSURER B: Pinnacol Assurance Company
INSURER C:
_
INSURER D:
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.
INSRADD'
LTR
INSR
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
DATE MMDDIYY
POLICY EXPIRATION
DATE fMMIDDIYYI
LIMITS
A
GENERAL LIABILITY
SCP008272106
06/09/08
06/09/09
EACH OCCURRENCE
$1 000 000
NCOM', ERCIAL GENERAL LIABILITY
AIMS MADE 51OCCUR
DAMAGE TO RENTED$1O0
000
MED EXP (Anyone person)
$10 000
PERSONAL & ADV INJURY
$1 000 000
GENERAL AGGREGATE
$2 00Q 000
GENT AGGREGATE LIMIT APPLIES PER:
PRODUCTS COMP/OP AGO
s2,000,000
POLICY PECOT LOC
AUTOMOBILE
LIABILITY
ANY AUTO
COMBINED SINGLE LIMIT
(Ea accident)
$
BODILY INJURY
(Per person)
$
ALL OWNED AUTOS
SCHEDULED AUTOS
BODILY INJURY
(Per accitlenq
$
HIRED AUTOS
NON -OWNED AUTOS
PROPERTY DAMAGE
(Per accident)
$
GARAGE LIABILITY
AUTO ONLY - EA ACCIDENT
$
OTHER THAN EA ACC
$
ANY AUTO
$
AUTO ONLY: AGG
EXCESS/UMBRELLA LIABILITY
EACH OCCURRENCE
$
AGGREGATE
$
OCCUR CLAIMS MADE
S
$
DEDUCTIBLE
$
RETENTION $
B
WORKERS COMPENSATION AND
4110277
12/01/07
12/01/08
X )NCSLATU TS I OTH-
EMPLOYERS' LIABILITY
ANY PROPRIETORIPARTNER/EXECUTIVE
E.L. EACH ACCIDENT
$100,000
E.L. DISEASE - EA EMPLOYEE
$100,000
OFFICER/MEMBER EXCLUDED?
If yes, describe under
E.L. DISEASE -POLICY LIMIT
$500,000
SPECIAL PROVISIONS below
OTHER
DESCRIPTION OF OPERATIONS 1 LOCATIONS / VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS
The City of Fort Collins is named an Additional Insured as regards their
interests.
City of Fort Collins
PO Box 580
Fort Collins, CO 80522
LD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL .j' 0_ DAYS WRITTEN
E TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
iE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
A HOI RIZED PR�,SEM& _
HwrtU cD tzUVHU0) 1 of 2 #M38473 SLF 0 ACORD CORPORATION 1988
ll'Oi_
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-S (2001/08) 2 of 2 #M38473