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Home My WebLink AboutNORMANDIN CONSTRUCTION INC - INSURANCE CERTIFICATE (2)OP ID: KH '`' CERTIFICATE OF LIABILITY INSURANCE °A'°"""'--- 10/04 10/04/11 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 CONT-NAMEACT IDES484 Insurance Group, St 970-635-9401 4648 Thompson Pkwy, Ste 200 Johnstown, CO 80534 John Hintzman pHCNNOExt:INC, No: ADE-DRESS:MAIL PRODUCER NORMA-1 CUSTOMER ID x, INSURERS AFFORDING COVERAGE NAIC q INSURED Normandin Construction, Inc. INSURERA:Mountain States Insurance Grp 1903 Silvergate Road INSURER B: Pinnacol Assurance 524210 Fort Collins, CO 80526 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 LTR TYPE OF ADDL SUB POLICYNUMBER POLICY EFF MMIDD/YYYY POLICY EXP MWDDIYI'YY LIMITS A A A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY GLAIMSWADE FK OCCUR X BLANKET ADD'L INS CPP0120772 CPP0120772 CPP0120772 04/01/11 04101111 04/01111 04/01/12 04/01/12 04/01/12 EACH OCCURRENCE $ 1,000,000 PREMISES E.mourance $ 100,00 MED EXP (Any one person) $ 10,00 PERSONAL a ADV INJURY $ 1,000,000 X BLANKET WAIVER OF GENERAL AGGREGATE $ 2,000,00 GEHL AGGREGATE LIMIT APPLIES PER. POLICY X PRO LOC PRODUCTS - COMP/OP AGG $ 2,000,00 $ A AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON-OWNEDAUTOS BAP0120772 04/01I71 04I01112 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 X BODILY INJURY (Per person) $ BODILY INJURY(Per accident) $ PROPERTY DAMAGE (Per accident) $ X X $ $ A UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE UMB0120772 04/01/11 04/01/12 EACH OCCURRENCE $ 1,000,00 AGGREGATE $ 1,000,00 DEDUCTIBLE RETENTION $ 0 $ X r $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETORIPARTNERrEXECUTIVE YIN OFFICERIMEMBER EXCLUDED? (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS helm NIA _LIM 4097258 11/01111 11/01/12 X WC STATUS X OTH- E.L. EACH ACCIDENT $ 1,DDD,UDD E. L. DISEASE - EA EMPLOYEE $ 1,000,00 E.L. DISEASE -POLICY LIMIT $ 1,000,00 C Equipment Floater Ded. $1,000 CPPOt20772 04/01/it 04/01I12 Scheduled 208,00 Leas/Rent 100,00 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, it 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 V 1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009/09) The ACORD name and logo are registered marks of ACORD