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Home My WebLink AboutTICO ROOFING - INSURANCE CERTIFICATEACORQ. CERTIFICATE OF LIABILITY INSURANCE CERTIFIC012 ATENO./ DATE ACERTIFI ATE NOi 1390E 10/S/2008 2:90:27PM PRODUCER 14160 Dal Risk Services LLC Dallas Parkway k500 Dallas, Dallas, TX 75254 (800) 632-5096 (972) 715-0959 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. Fax: (972) 404-4450 INSURERS AFFORDING COVERAGE INSURED: AMS Staff Leasing 1 C f: TICO ROOFING PO BOX 154 INSURERA: DALLAS NATIONAL INSURANCE COMPANY INSURER B: INSURER C: TIMNATH, CO 80547 (9'70) 391-0204 Pax: (970) 267-7005 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. II-TRNSR TYPE OF INSURANCE POLICY NUMBER POLICY FFE (MMfDDfYYI OLLII YEXPIATE OFATI PTE LIMITS GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY CLAIMS MADE OCCUR FIRE DAMAGE (Any One Fire) S MED EXP(Any one person) S PERSONAL &ADV INJURY 5 GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGO S POLICY PRO' LOG AUTOMOBILE LIABILITY ANYAUTO COMBINED SINGLE LIMIT (Ea accident) 5 ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY (Pe, person) 5 HIREDAUTOS OWNED AUTOS BODILNON (Per.' d.m) (Per accident) S PROPERTY DAMAGE (Per acadeo0 S GARAGE LIABILITY AUTO ONLY -EA ACCIDENT S ANY AUTO OTHER THAN EA ACC S AUTO ONLY: AGG 5 EXCESS LIABILITY OCCUR CLAIMS MADE EACH OCCURRENCE $ AGGREGATE $ DEDUCTIBLE 5 RETENTION 5 S WORKERS COMPENSATION AND EMPLOYERS' LIABILITY DWCO2000505 09/24 /2005 06/20 /2009 WC STATU, OTH- E.L. EACH ACCIDENT is 1000000 A E.L. DISEASE - EA EMPLOYEE $ lODOU 00 E.L. DISEASE -POLICY LIMIT 1 $ 100000 OTHER LIMITSLIFE $ LIMITS 5 1. Thrs certificate remarNSNI nS in e`fact, prove eDEy t e c Lent'S account is in good standing with AMS Staff Leasing. Coverage is not provided for any employee for which the client is not reporting wages to AMS Staff Leasing. Applies to 100% of the employees of AMS Staff Leasing leased to TIGO ROOFING, effective 09/29 /2008. e Insured afforded Workers Compensation & Employers liability as a co -employer under the policy for employees leased sed from AMS Staff Leasing. CITY OF FORT COLLINS- FAX. 970-224-6131 P.0 BOX 580 FORT COLLINS, CO 805220580 ACORD 25-S (7/97) BE CANCELLED BEFORE THE EXPIRATION DATETHEREOF, THE ISSUINGINSURER WILLENDEAVOR TOMAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TOTHELEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATIONOR LIABILITY OFANY KIND UPON THEINSURER, RSAGENTSOR AUTHORIZED REPRESENTATIVE 1988