HomeMy WebLinkAboutA AND H ROOFING - INSURANCE CERTIFICATECERTIFICATE OF LIABILITY INSURANCE
American Family Insurance Company ❑
American Family Mutual Insurance Company if selection box is not checked.
6000 American Pky Madison, Wisconsin 53783-0001
Insured's Name and Address Agent's Name, Address and Phone Number (Aot./Dist.)
A & H Roofing Daniel A Bott (303) 452-6465
12988 County Rd 4 9035 Wadsworth Blvd. # 3800
Brighton, CO 80603 Westminster CO 80021
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 listed below.
COVERAGES
This is to ce tily that 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.
TYPE OF INSURANCE
POLICY NUMBER
LIMITS OF LIABILITY
EFFECTIVE EXPIRATION
Mo Da YrIMP, Day, Yr
Homeowners/
Botlily Injury antl Property Damage
Mobilehomeowners Liability
Each Occurrence $ '000
Boatowners Liability
Bodily Injury and Property Damage
Each Occurrence $ ,000
Personal Umbrella Liability
Potlly Injury and Property Damage
Each Occurrence $ 1000
Farm/Ranch Liability
Farm uamrs Personal uamury
Each Occurrence $ 1000
Farm Employer's Liability
Each Occurrence $ 000
Workers Compensation and
Employers Liability t
Statutory ,,,,,,,,•,,,
Each Accident $ '000
Disease Each Employee $ 1000
Disease Policy Limit $ .000
General Liability
® Commercial General
Liability (occurrence)
❑
05-XA7071-03-00
4/75/2008
4/15/2009
General Aggregate $ 2,000 000
Products- Completed Operations aggregate $ 2,000 ,000
n
Personal end Advenism u $ 1,000 .000
= In/--�-
--
Each Occurrence — $ 1,000'000
❑
Damage to Premises Period to You $ 100 000
Medical Expense (Any One Person) $ 5 o0o
Businessowners Liability
Each occurrencet t $ 1000
Aggregate}} $ 1000
Liquor Liability
Common Cause omit $ ,000
Aggregate Limit $ .000
Automobile Liability
❑ Any Auto
Bodily lnJuN-Each Person $ ,000
❑ All Owned Autos
❑ Scheduled Autos
Bodily Injury - Each Accident $ 1000
❑ Hired Auto
Property Damage $ 1000
❑ Nonowned Autos
'
❑
Bodily Injury and Properly Damage Combined $ 1000
Excess Liability
❑ Commercial Blanket Excess
❑
Each Occurrence/Aggregate $ 000
Other (Miscellaneous Coverages)
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/flESTRICTIONS/SPECIAL ITEMS t The individual or partners shown as insured ❑Have ❑Have not
elected to be covered as employees under this policy,
t t Products -Completed Operations aggregate Is equal to each
occurrence limit and is Included in policy aggregate.
' CERTIFICATE HOLDER'S NAME AND ADDRESS
CANCELLATION
• City of Fort Collins
O Box 580otice
Collins CO 80522hall
ld any of the above described policies be cancelled before then date thereof, the company will endeavor to mail'( 30 days)P
to the Certificate Holder named, but failure to mail suchFort
impose no obligation or liability of any kind upon they, its agents or representatives. ' y0 days unless different of days shown.Fax
iimim
970-224-6134
certifies coverage on the date of issue only. The aboved policies are subject to cancellation in conformity with theird by the laws of the state of issue.
DATE ISSUED
12/19/2008
AU ORIZ REP SEAT/IV
U-201 Ed. 5/00 Office Stock No. 06668 Rev. 7/02