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Home My WebLink About101127 4-K PAINTING AND DRYWALL INC - INSURANCE CERTIFICATE (2)ACORDa CERTIFICATE OF LIABILITY PRODUCER (970)223-0924 FAX (970)267-2231 Colorado BW Insurance Agency, Inc /DD08 INSURANCE DATEo7/25/z0os THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 1075 W Horsetooth Rd Ste 106 Fort Collins, CO 80526 HOLDER THIS CERTIFICATE DOES NOT AMEND EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW INSURERS AFFORDING COVERAGE NAIC # INSURED 4K Painting & Drywall Inc 2900 Galway Laporte CO 80535 INSURERA Continental Western Group INSURERS Pinnacol Assurance INSURER INSURER D INSURER E 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 INSR ADD I_LM BM TYPE OF INSURANCE POLICY NUMBER POLICYEFFECTIVE 07/23/2008 POLICY EXPIRATION LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS MADE O OCCUR CNP270615822 07/23/2009 EACH OCCURRENCE $ 1,000 00 DAMAGE TO RENTED $ ZSO, OO $ S 00 MED UP (Any one Person) PERSONAL S ADV INJURY $ 1 000,00 GENERAL AGGREGATE $ 2 000,00 GEN L AGGREGATE LIMIT APPLIES PER X POLICY jEo LOC PRODUCTS COMP/OP AGG $ 2,000 00 AUTOMOBILE LIABILITY ANY AUTO COMBINED SINGLE LIMIT (Ea accident) $ ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY (Per Person) $ HIRED AUTOS NON OWNED AUTOS BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY AUTOONLY EAACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY AGG $ EXCESS/UMBRELLA LIABILITY OCCUR CLAIMS MADE EACH OCCURRENCE $ AGGREGATE $ DEDUCTIBLE RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS LIABILITY 4080430 07/01/200$ D7/01/2009 X WC STATU OTH EL EACH ACCIDENT $ 100,00 B ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? E L DISEASE EA EMPLOYE $ 100,000 H yea desci be under SPECIAL PROVISIONS below OTHER I F E L DISEASE POLICY LIMIT $ S00 r 0D DESCRIPTION OF OPERATIONS /LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS City of Fort Collins PO Box 580 Fort Collins, CO 80522 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE I URER ITS AGENTS OR REPRESENTATIVES AUTHORIZED BEEREN I�1 Leslie Shade O✓1�//l (/ ACORn 9617AAvnRi FAX 4A7-776A WAl IJKIJ LRJKYUKA I KUN 1888 IMPORTANT If the certificate holder is an ADDITIONAL INSURED the policy(ies) must be endorsed A statement on this certificate does not confer nghts 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