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HomeMy WebLinkAboutSINNETT BUILDERS - INSURANCE CERTIFICATE (4)ACORD CERTIFICATE OF LIABILITY INSURANCE OP ID KH SINNE-1 DATE(MM/DD/YYYY) 07/30/09 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE LEIN Insurance Agcy-Johnstown HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 4848 Thompson Pkwy, Ste 200 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Johnstown CO 80534 Phone: 970-635-9400 Fax: 970-635-9401 INSURERS AFFORDING COVERAGE NAIC # INSURED INSURER A: EP$C Insurance Companies INSURERB: Pinnacol Assurance Sinnett Builders Inc. SB Construction LLC IBP 14 Cor PO Box 1963 Fort Collins CO 80522 INSURERC: 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. INS LTR NSR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE MM/DD/YY POLICY EXPIRATION DATE MM/DD/YY LIMITS A X GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS MADE® OCCUR X Banket AI 3X2 3 7 6 9 FORM CG7482 FROMCG7555 0 6/ 3 0/ 0 9 0 6/ 3 0/ 10 EACH OCCURRENCE $ 1, 000, 000 PREMISES (Ea occurence) $ 3 00 r 0 0 0 MED EXP (Any one person) $ 5 000 PERSONAL & ADV INJURY $1,000,000 X Blanket Waiver GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY X PRO LOC JECT PRODUCTS - COMP/OP AGG $ 2 , 0 00 , 0 00 AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY ANY AUTO AUTO ONLY -EA ACCIDENT $ $ $ OTHER THAN EA ACC AUTO ONLY: AGG A EXCESS/UMBRELLA LIABILITY X I OCCUR �CLAIMSMADE DEDUCTIBLE X RETENTION $ 10 , 000 3X23769 06/30/09 06/30/10 EACH OCCURRENCE $ 5,000,000 AGGREGATE $5,000,000 $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? It yes, describe under SPECIAL PROVISIONS below TORY LIMITS I I ER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ $ E.L. DISEASE - POLICY LIMIT OTHER DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS insureds with respects to the general liability. CERTIFICATE HOLDER CANCELLATION CITYFOR 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 DO SO SHALL City of Fort Collins IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR 300 LaPorte Ave. REPRESENTATIVES. Fort Collins CO 80522 AUT la AEq RESE ATIV ACORD 25 (2001/08) © ACORD CORPORATION 1988