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441491 ALPINE DEMOLITION & RECYCLING - INSURANCE CERTIFICATE
A� L' CERTIFICATE OF LIABILITY INSURANCE DATE oa/no1m1201P ) 1 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 endorsemenl(s). PRODUCER Phone'. (303)972£633 Fax: (303)972-6655 IRG - AFFINITY INSURANCE PARTNERS, LLC 7991 SHAFFER PARKWAY, SUITE 300 LITTLETON CO 80127 CONTACT Rose Cantrell NAME: PHONE 303 972-6633 (FAX 303 972-6655 LNG-E-W,VE*�( ) DC, NPy. ( ) ADDRESS rcantrall@irgco.com PRODUCER 24779 CUSTOMER ID INSURER(S) AFFORDING COVERAGE NAIC N INSURED ALPINE DEMOLITION INSURER Pinnacol Assurance 5790 WEST 56TH AVENUE INSURER INSURER ARVADA CO 80002 INSURER D: INSURER INSURER COVERAGES CERTIFICATE NUMBER: 36093 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 TYPE OF INSURANCE I ADD'LI INSR SURE WVO POLICY NUMBER POLICY EFF MM_IDDIYYYY) POLICY EXP (MWDDryYYY) LIMITS EACH OCCURRENCE $ _L_T_R GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY _ CLAIMS -MADE (OCCUR DAMAGE TO RENTED PREMISES (Eaomu,ence) MED. EXP(Anyone person) $ $ PERSONAL& ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ LOC POLICY PRO El JECT $ _ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident) IS ANY AUTO BODILY INJURY (Per person) $ ALL OWNED AUTOS BODILY INJURY (Per accident) $ SCHEDULED AUTOS PROPERTY DAMAGE HIREDAUTOS (Per accident) $ $ NON -OWNED AUTOS is UMBRELLA LIAB I OCCUR EACH OCCURRENCE $ EXCESS LIAR CLAIMS -MADE (AGGREGATE $ DEDUCTIBLE $ $ $ I RETENTION $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETORIPARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory In NH) N/A 4000961 05101111 05/01j12 X WCSTATU- TORY LIMIT$ PR E_L. EACH ACCIDENT $ 500,000 E.L. DISEASE -EA EMPLOYEE - $ 500,000 If yes, desonde under DESCRIPTION OF OPERATIONS below EL DISEASE -POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) CERTIFICATE HOLDER CANCELLATION City of Fort Collins SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 215 NOrth Mason Street THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Fort Collins, Co. 80524 1 AUTHORIZED REPRESENTATIVE Attention: n D � Ros a� �ORD 25 (2009/09) © 1988-2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD A� L' CERTIFICATE OF LIABILITY INSURANCE DATE oa/no1m1201P ) 1 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 endorsemenl(s). PRODUCER Phone'. (303)972£633 Fax: (303)972-6655 IRG - AFFINITY INSURANCE PARTNERS, LLC 7991 SHAFFER PARKWAY, SUITE 300 LITTLETON CO 80127 CONTACT Rose Cantrell NAME: PHONE 303 972-6633 (FAX 303 972-6655 LNG-E-W,VE*�( ) DC, NPy. ( ) ADDRESS rcantrall@irgco.com PRODUCER 24779 CUSTOMER ID INSURER(S) AFFORDING COVERAGE NAIC N INSURED ALPINE DEMOLITION INSURER Pinnacol Assurance 5790 WEST 56TH AVENUE INSURER INSURER ARVADA CO 80002 INSURER D: INSURER INSURER COVERAGES CERTIFICATE NUMBER: 36093 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 TYPE OF INSURANCE I ADD'LI INSR SURE WVO POLICY NUMBER POLICY EFF MM_IDDIYYYY) POLICY EXP (MWDDryYYY) LIMITS EACH OCCURRENCE $ _L_T_R GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY _ CLAIMS -MADE (OCCUR DAMAGE TO RENTED PREMISES (Eaomu,ence) MED. EXP(Anyone person) $ $ PERSONAL& ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ LOC POLICY PRO El JECT $ _ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident) IS ANY AUTO BODILY INJURY (Per person) $ ALL OWNED AUTOS BODILY INJURY (Per accident) $ SCHEDULED AUTOS PROPERTY DAMAGE HIREDAUTOS (Per accident) $ $ NON -OWNED AUTOS is UMBRELLA LIAB I OCCUR EACH OCCURRENCE $ EXCESS LIAR CLAIMS -MADE (AGGREGATE $ DEDUCTIBLE $ $ $ I RETENTION $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETORIPARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory In NH) N/A 4000961 05101111 05/01j12 X WCSTATU- TORY LIMIT$ PR E_L. EACH ACCIDENT $ 500,000 E.L. DISEASE -EA EMPLOYEE - $ 500,000 If yes, desonde under DESCRIPTION OF OPERATIONS below EL DISEASE -POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) CERTIFICATE HOLDER CANCELLATION City of Fort Collins SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 215 NOrth Mason Street THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Fort Collins, Co. 80524 1 AUTHORIZED REPRESENTATIVE Attention: n D � Ros a� �ORD 25 (2009/09) © 1988-2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD