HomeMy WebLinkAboutPERFORMANCE SURFACING EXTERIOR ADVANTAGE - INSURANCE CERTIFICATE7/18/2011 3:12 PM FROM: Centennial -Insurance Centennial Inaurance Aq.nry, LLC TO: 9702216707 PAGE: 002 OF 002
'M%OwRw CERTIFICATE OF LIABILITY INSURANCE
DATI!XMIDD/YTTYI
07/15/2011
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 CONSTITUTEA CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER AND THE CERTIFICATE HOLDER.
IMPORTANT: R Du nrDlVate holder l6 an ADDITIONAL INSURED, the paUcy(iaa) must to elroorsed. BSUBROGNTIONISWANED,stiWito,
the hums and candillow of the policy, oedaln polldes may require an endorsement A stalement on Dtls carDecate does not corder eahts to the
tartficam holder in Mau of wC, andosenreed(s}
rrtaollCeR
Centennial Insurance Agency, LLC
1SIS Fortino Blvd. god Floor
Pueblo, CO 81003
NAsae:
I"ORH E : 719.544.1111 TAx „ 719.S4S.S120
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INSURED
Ridgeline Construction Inc
DBA: Performance Surfacing Exterior Advantage
752 E. Sandusky
Pueblo West, CO S10D7
IMIIU 1A: Addison Insurance Company
1024
eNeegege; Pinnacol Assurance
41190
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MSUItER F
COVERAGES CERTIFICATE NUMBER: 2011 - 2012
REVISION NUMRFR:
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 CONORION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAYBE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BYTHE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
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DESCRIP OF0P 1710115I IDCATIDIM I VEMU11 IARWI, ACORD rat. Mel A Ranleel ere,eas, Of ware anW ,.m
eloW named certificate holder is named as additional insured under GL
6707
SHOULD ANYOF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE W0.l BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
City of Ft. Collins
Purchasing Department AUTNONSD REPOMM11TAIWE
P.O. Box 280 �"t" ;�' `I.;,—
FLy Collins, CD BOS22 Patricia Files/PAT
ACLIKU 25 (ZMM9) The ACCORD name and logo are regletared marks of ACCORD