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HomeMy WebLinkAboutBAESSLER CONSTRUCTION CO INC - INSURANCE CERTIFICATEOP ID: KH iI11 CERTIFICATE OF LIABILITY INSURANCE - ----UAT03/28WYYYY,-_ 03/28/12 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 970-635-9400 CONTACT PFS Insurance Group -JT 970-635-9401 4848 Thompson Pkwy, Ste 200 Johnstown, CO 80534 John Hintzman PNONE Fax A/C No Eat): A/C No): E-MAIL ADDRESS: PRODUCER gAESS-1 CUSTOMER ID #: INSURERS AFFORDING COVERAGE NAIL# INSURED Baessler Construction Co, Inc. INSURER A: Mountain States Insurance Grp Baessler Homes, LLLP 3505 Holman Court Greeley, CO 80631 INSURER B: Builders Insurance Group INSURER c : Pi nnacol Assurance 524210 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 R TYPE OF INSURANCE ADOL VIVOSUBS POLICYNUMBER EFF MMIDOPOLICYYYYY Y EXP MMIDDYYYY LIMITS B GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE a OCCUR GLP011756600 01/01/12 01/01/13 EACH OCCURRENCE $ 1,000,00 PREMISES Ea oownence $ 100,000 MED EXP (Any one person) $ 5,00 PERSONAL SADVINJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,00 GENL AGGREGATE LIMIT APPLIES PER: X POLICY PRO LOC PRODUCTS - COMP/OP AGG $ 2,000,0010 $ A AUTOMOBILE LIABILITY ANY Auro ALL OWNED AUTOS SCHEDULED AUTOS HIREDAUTOS NON-OWNEDAUTOS BAP0213450 03/28/12 03/28113 COMBINED SINGLE LIMIT F. accident) $ 1,000,000 X BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Peraccident) $ X X $ B UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE UMB011795900 01I01112 01/01113 EACH OCCURRENCE $ 1,000,00 AGGREGATE $ 1,000,00 DEDUCTIBLE RETENTION $ 0 $ X $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below NIA _CRY 4052202 01I01112 01/01/13 X I WC STATU- OTH- ER- E.L. EACH ACCIDENT $ 100,000 E.L. DISEASE - EA EMPLOYEE $ 100,00 EL.DISEASE - POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) All Operations - All Locations. CITYFT3 City of Fort Collins P.O. Box 580 Ft. Collins„ CO 80522.0585 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 4a�,__, © 1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009109) The ACORD name and logo are registered marks of ACORD