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Home My WebLink About399198 FRONT RANGE ROOFING SYSTEMS - INSURANCE CERTIFICATE (4)riianl$• 19172 ACORDr,, CERTIFICATE OF LIABILITY INSURANCE (MMID 0DATE 4/20/4/20/09DIYYYY) PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Flood & Peterson Ins. Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE P. O. Box 578 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 4687 W. 18th Street Greeley, CO 80632 INSURERS AFFORDING COVERAGE NAIC # INSURED Front Range Roofing Systems LLC INSURER A. Continental Western Group INSURER B: Pinnacol Assurance 222 13th Ave INSURER C: Greeley, CO 80631-2272 INSURER D: INSURER E' 1. 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, IN R -A-95`1 POLICYEFFECTIVE POLICYEXPIRATION LTR INSR1 TYPE OF INSURANCE POLICY NUMBER DATE MMIDD/YY DATE MMIDDIYY LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS MADE aOCCUR CWP2564246 05/01/09 05/01/10 EACH OCCURRENCE $1006000 DAMAGE TO RENTED PRFMI rr n $100 000 MED EXP(Any one person) $5000 X PD Ded:5,000 PERSONAL & ADV INJURY $1,000,000 GENERAL AGGREGATE $2 000 000 GENT- AGGREGATE LIMIT APPLIES PER: POLICY 7X PRO- IECT 7 LOC PRODUCTS - COMP/OP AGO $2006000 A AUTOMOBILE X LIABILITY ANY AUTO CWP2564246 05/01/09 05/01/10 COMBINED SINGLE LIMIT (Ea accident) $1,000,000 ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY (Per (Per person) X HIRED AUTOS NON -OWNED AUTOS BODILY INJURY (Per accident) $ X PROPER I DAMAGE (Per accident) $ GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ $ AUTO ONLY: AGO A EXCESS/UMBRELLA LIABILITY AlOCCUR CLAIMS MADE CU2573577 05/01/09 05101/ 00 EACH OCCURRENCE s5,000,000 AGGREGATE $5 000 000 DEDUCTIBLE $ RETENTION _$ B B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOWPARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? If yes, describe under 1946560 1946560 06/01/09 06/01/08 06/01/10 06/01/09 X WC STATU- OTH- El EACH ACCIDENT $1,000,000 E.L. DISEASE -EA EMPLOYE $1,000,000 E.L. DISEASE -POLICY LIMIT $1,000,000 SPECIAL PROVISIONS below OTHER DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS City of Fort Collins P O Box 580 Fort Collins, CO 80522 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 DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR r r . ' n mrwv a oo DSM © ACORD CORPORATION 1988 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. AUUKU Z5.5 (ZUUMB) 2 of 2 #M441760