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HomeMy WebLinkAboutNORMANDIN CONSTRUCTION INC - INSURANCE CERTIFICATEOP ID: KH OF LIABILITY -INSURANCE-- °YYCERTIFICATE --- ' - 03/29111 -- THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS' CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. 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 endorsements . PRODUCER 970-635-9400 PFS Insurance Group - JT 4848 Thompson Pkwy, Ste 200 970-635-9401 Johnstown, CO 80534 John Hintzman CONTACT PHONE FA% A/C No Eat , AIC NO); I E-MAILADDRESS I PRODUCER 1uSTOMERID#:N0RMA-1 - INSURERS AFFORDING COVERAGE NAIC#' - - INSURED Normandin Construction, Inc. INSURER A: Mountain States Insurance Grp ' 1903 Silvergate Road Fort Collins, CO 80526 INSURERS; Pinnacol Assurance 41190 INSURER C INSURER D INSURER E INSURER F COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT 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. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TR TYPE OF INSURANCE ADD L SUB POLICY NUMBER MMY IDD/YYYY MM IDO/YYYY LIMITS A A A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE FxI OCCUR X BLANKETADD'LINS CPP0120772 CPP0120772 CPP0120772 04I01111 04/01/11 04/01/11 04I01/12 04101/12 04/01/12 EACH OCCURRENCE $ 1,000,00 PREMISES Ea occurrence $ 100,00 MED EXP (Any one person) $ 10,00 PERSONAL B ADV INJURY S 1,000,00 X BLANKETWAIVEROF GENERAL AGGREGATE $ 2,000,00 GEN'L AGEGAEAPPLIES PER'. POLICYGRXT'LEI PRO- AIT LOC PRODUCTS AGG $ 2,000,00 - $ A AUTOMOBILE LIABILITY ANYAUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS - NON -OWNED AUTOS 13AP0120772 - 04/01111 - 04/01/12 - COMBINED SINGLE LIMIT (Ea accident) $ _ 7,000,00 X BODILY INJURY (Per person $" '- -- BODILY INJURY (Par accitlent) $--' - PROPERTY DAMAGE- (Per accident)- - - $ X X $ $ A UMBRELLA LIAR EXCESS X OCCUR CLAIMS -MADE. - UMB0120772 - 04/01111 04I01112 EACH OCCURRENCE $ 1,000,00 AGGREGATE $ 1,000,00 DEDUCTIBLE RETENTION $ $ X E _ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N - ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, d-scribe under DE SCRIPTION OF OPERATIONS below - - N/A 4097258 11101/10-`11101111-'E.L, X WC STATU- X OTH- IR EACH ACCIDENT' - - $ ------.1,000.00 E.L DISEASE - EA EMPLOYEE $ 1,000,00 E. L. DISEASE -POLICY LIMIT $ 1,000,00 C Equipment Floater Ded. $1,000 CPP0120772 04101111 04/01/12 Scheduled 196,00 Leas/Rent 100,00 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space Is required) All Locations / All Operations If required by written contract or written agreement, certificate holder is included as additional insured for ongoing operations under General Liability. CITYFT3 City of Fort Collins P.O. Box 580 Ft. Collins„ CO 80522 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE .6G�Y ----, ©1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009109) The ACORD name and logo are registered marks of ACORD