HomeMy WebLinkAbout130163 EMPIRE CARPENTRY LLC - INSURANCE CERTIFICATE (4)ACCER CERTIFICATE OF LIABILITY INSURANCE
DATE,MM312011 YY)
on,a,2o„
PRODUCER CER
PINNACOL ASSURANCE
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY
7501 E Lowry Blvd
Denver, CO 80230-7006
AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE
COVERAGE AFFORDED BY THE POLICIES BELOW.
INSURERS AFFORDING COVERAGE NAIC#
INSURED
EMPIRE CARPENTRY LLC
INSURER@ PINNACOL ASSURANCE
41190
INSURER B:
521.5 SYCAMORE ST
INSURER
FORT COLLINS, CO 80521
INSURER D.
INSURER E'.
COVERAGES
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDNG
ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMMENT 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
I ADD'L
POLICY EFFECTIVE
POLICY EXPIRATION
LTR
INSRO
TYPE OF INSURANCE
POLICYNUMBER
DATE(MM11 IVY)
DATENANV IYYI'Y)
LIMITS
GENERAL LIABILITY
EACH OCCURRENCE
DAMAGE TO RENTED
COMMERCIAL GENERAL LIABILITY
CLAIMS MADE OCCUR
PREMISES
MED EXPRoyone Person)
PERSONAL& ADV INJURY
GEN'L AGGREGATE LIMIT APPLIERS PER:
GENERAL AGGREGATE
PRODUCTS-COMPIOPAGG
POLICY PROJECT LOC
AUTOMOBILE LIABILITY
COMBINED SINGLE LIMIT
ANY AUTO
(Ea AcccenN
BODILY I WURY
ALL OWNED AUTOS
SCHEDULEDAUTOS
(Per Moron)
BODILY INJURY
HIRED AUTOS
NON-OWNEDAUTOS
(Per accilenB
PROPERTTDAMAGE
(Per accident)
GARAGE LIABILITY
AUTO ONLY- EA ACCIDENT
OTHER THAN EA ACC
ANY AUTO
AUTO ONLY: AG
E%CESSIUMBRELLA LIABILITY
EACH OCCURRENCE
pGGREGATE
OCCUR CLAIMS MADE
DEDUCTIBLE
RETENTION S
WORKERS COMPENSATION AND
WC STATU- OTHER
A
EMPLOYER'S LIABILITY
ANY PROPRIETORIPARTNERIEXECUTIVE
1519590
09/01/2010
09/01/2011
TORY LIMITS
EL EACHACCIDENT
$100,000
OFFICERIMEMBER EXCLUDED?
EL DISEASECAEMPLOYEE
$100,000
It yes, pleasedescnbaunder SPECIAL PROVISIONS below
EL DISEASE -POLICY LIMIT
500000
OTHER
DESCRIPTION OF OPERATIONSILOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
CERTIFICATE HOLDER
CANCELLATION
1323717
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
City of Fort Collins- Purchasing
THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO
281 North College
MAIL 0 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE
Fort Collins CO 80521
LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR
LIABILITY OF ANY KIND UPON THE COMPANY, ITS AGENTS OR
REPRESENTATIVES.
AUTHORIZED REPRESENTATIVE
Charles Doggett
ACORD 25(2001/08)
Underwriter ACORD CORPORATION 1988