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Home My WebLink AboutJAMESTOWN BUILDERS LLC - INSURANCE CERTIFICATEClient#: 28612 JAMBU ACORD. CERTIFICATE OF LIABILITY INSURANCE DAT """DNYYY) ,/24/2012 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 endorsement(s). PRODUCER CONTACT NAME: Dana M Stewart Flood & Peterson Ins., Inc. PHONE g70 266 7149 FAX aC Nd ac, No): 970 506 6845 P.O. Box 578 nOOREss: Bane.stewartWfloodandpeterson.com Greeley, CO 80632 PRODUCERJAMBU CUSTOMERIO#: 970 356-0123 INSURER(S) AFFORDING COVERAGE NAIC M INSURED INSURER A: First Mercury Insurance Company 10657 Jamestown Builders LLC Assurance c/o Everitt Enterprises INSURER BPinnacol INSURER C. P Allianz Global Corporate & Spec 22837 3003 E Harmony Rd #400 Fort Collins, CO 80528 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 %DDL NSR 3UBR APID POLICY NUMBER POLICY EFF MWODNYYY) POLICY EXP (MMVDDNYYYT LIMITS A GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY CLAIMS -MADE 51 OCCUR X BIND Ded:10,000 MACGL0000003597- 01 1101/2012 01/01/2013 EACH OCCURRENCE $1000000 DAMAGE RENTED PREMISES � a occurrence) $100 000 MED EXP (Any one person) 35,000 PERSONAL&ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO LOC PRODUCTS - COMP/OP AGO s2,000,000 $ AUTOMOBILE LIABILITY ANYAUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON OWNED AUTOS COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per acciden) $ $ S UMBRELLA LIAR EXCESS LIAR OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE IS DEDUCTIBLE RETENTION $ $ $ B WORKERS COMPENSATION AND EMPLOYERS'DABILDY YIN ANY PROPRIETOWPARTNEWEXECUTIVE❑ OFFICEWMEMSER EXCLUDED? (Mandatory In NH) If yes, desenbe under DE SG RIPTION OF OPERATIONS below NIA 4150661 1/01/2012 01/01/2013 X WC U- STATOTH' TORYL 'ITS E.L. EACH ACCIDENT $500000 E.L. DISEASE - EA EMPLOYEE s500,000 EL. DISEASE -POLICY LIMIT s500,000 C Builders Risk MX198468514 1/01/2012 01/01/2013 $275,000 Limit $1.000 Deductible DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, it more space is required) Certificate holder is named as additional insured, but only as respects liability arising out of ongoing operations of the named insured (Excluding Workers' Compensation). City of Fort Collins PO Box 580 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 01988-2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009/09) 1 of 1 #S669508/M666604 The ACORD name and logo are registered marks of ACORD SXC