HomeMy WebLinkAbout448494 AAA WATERPROOFING INC - INSURANCE CERTIFICATE (2)AAAWA-1 OP ID:-WS
CERTIFICATE OF LIABILITY INSURANCE -- -
DAT`12/30D""""'
12/30/11
.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
BEL•OW.• .THIS CERTIFICATE -'OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER)S), AUTHORIZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. ..0
--if certificat
•- a holder is an ADDITIONAL INSURED, the policylies) must be endorsed." If SUBROGATION IS WAIVED, subject to
,. ,..
thelterms aI d conditions of the policy, certain policies may require an endorsement.. A statement on this certificate does. not confer rights to the.
_ _
' certificate holoerin lieu of such endorsementis). — ` - ----- - --- ----- -
PRODUCER - ___ 303-996-7801
CRS eraBrokerage I
Commerciciall Ri Risk Solutions DBA 303-757-7719
CONTACT I _. _r,.• j. _. - _ _. _._.
NAME.
PHONE - FAX —
_lac, No, Ext)_ '1(AIC no) -
E-MAIL - - _- ---- _
ADDRESS:
6600 E. Hampden Ave.. ? ' -, I
Denver, CO 80224
`—
Scott M. While, CIC, ARM -
INSURERS AFFORDING COVERAGE "NAIC a
INSURER A:Companion Specialty Ins. CO.
INSURED Bea Waterproofing, Inc.
INSURER : Westfield Insurance Co.
8510 Willow Street
Commerce City, CO 80022
INsuRERc: Pinnacol Assurance
INSURER D :
INSURER E :
INSURER F :
COVFRAnFA CFRTIFICATF NI IMRFR- RFVLC1r1MMIIMRFR-
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 INSURANCE
ADDL
SUER
POLICY NUMBER
POLICY EFF
MMIOD/YVVV
POLICY EXP
MMIDDNYYY
LIMITS
GENERAL LIABILITY
EACH OCCURRENCE
$ 1,000,00
A
X COMMERCIAL GENERAL LIABILITY
I�ICLAIMS-MADE nOCCUR
VGLI131462
01/01/12
01/01/13
15-AMAGE TGREOTYD
PREMISES (Ea o wna.-L
I S 50,000
MEDEXP(Anyoneperson)
I$ Excluded
' - •.
PE RSONAL dADV INJU RY-
IS -"" 1,000,000
-Y
GENERAL AGGREGATE'.:`{$
2,000,000
J
GEN L AGGREGATE LIMIT APPLIES PER:
-.
POLICY.X.-,PRO r. Fi LOC ,. .S,
IPrT
PRODUCTS COMP/OP AGG
$ 2,000,00
iR
-
.q:
_
- i ,' c
,,,.•-, a, ..
_ __-....
B--------- .-,.
B.'
AUTOMOBILE LIABILITY JI --
,'-. ..,r
X ANY AUTO `. z.I(((S—������II"t L `
AUTOS ALLOWNED I�f.AUTOSULED' -�
-~
.=..TRA4985352-;
�'• '
-"-'
01101/12-
_
-:'
-01/01/131-�BODILY4NJURV(Per
COMBINED, SINGLELIMIT,
Eaadc,de,) -
1$1, ��1000,00
T
Person)rl$�_
_. -
it C.': r;
BODILY INJURY(P acdidero
..
$
X HIREDAUTOS X NON -OWNED
Il
AUTOS
�-.-
•-PROPERTVDAMAGE
•._$',.
(Per acc,tlenlj
-
I$
(UMBRELLA LIAR
X
OCCUR
EACH OCCURRENCE
$ 2,000,00
AGGREGATE
$ 2,000,00
A
X' EXCESS LIAB
CLAIMS -MADE
VUE1221551
01/01/12
01/01/13
DED I X I RETENTIONS D
$ -'
C
iIt
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY
ANY PROPRIETOR/PARTNER/EXECUTIVE YIN
OFFICER/MEMBER EXCLUOED9 O
(Marrdatnry in NH)
yes, describe under
DESCRIPTION OF OPERATIONS below
N/A
I
4051555
01/01/12
01/01/13
X WC STATU I OTH-
QRY LIMITS_l�._ER_
$ 500,000
E.L. EACH ACCIDENT
I
E.L. DISEASE EA EMPLOYEE'
E.L. DISEASE POLICY LIMIT
$ 500,00
—'--- —'---
I $ 500,00
B
Rented/Leased
TRA4985352
01/01/12
111101113
Limit 10,000
Equipment
Ded. 5,000
DESCRIPTION OF OPERATIONS I LOCATIONS/ VEHICLES (Attach ACORD 101, Additional Remarks Schedula, If more space Is required)
Re: CSU Transit Center.
CIFORTC
City of Fort Collins
117 N. Mason Street
Fort 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
3��p
U 1988.2010 ACORD CORPORATION. All rights reserved.
ACORD 26 (2010/05) The ACORD name and logo are registered marks of ACORD