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Home My WebLink About262877 RTN ROOFING SYSTEMS LLC - INSURANCE CERTIFICATEA ^r%r2r% CERTIFICATE OF LIABILITY INSURANCE D /D 04/02/02/2012) 012 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). vaooucER Ewing -Leavitt Insurance Agency CONTACT NAME: renee-mcreynolds@leavitt.com NHCONri,EXt:970.679.7344 aCNe:866.425.6180 AIL ADDRESS: renee-mcreynolds@leavitt.com 4025 St. Cloud Dr. Suite 100 PRODUCER 00008600 CUSTOMER ID #: INSURER(S) AFFORDING COVERAGE NAIC# Loveland, CO 80538 INSURED -Alq L INSURER A: Plnnacol Assurance 41190 INSURER B: I RTN Roofing Systems, LLC INSURER C: 5854 Lockheed Ave INSURER D: Loveland, CO 8OS38 INSURER E: INSURER F COVERAGES CERTIFICATE NUMBER: 12-13 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 CONTRACTOR 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 INSR SUBR WVD POLICY NUMBER POLICY EFF MMIDD/YYYY POLICY EXP MMIDD/YYYY LIMITS GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR EACH OCCURRENCE $ DAMAGE TO RENTED PREMISES Ea occurrence $ MED EXP (Any one person) IS PERSONAL & ADV INJURY $ GENERALAGGREGATE $ GENL AGGREGATE LIMIT APPLIES PER: POLICY n JE RGr LOG PRODUCTS - COMP/OP AGG $ AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS COMBINED SINGLE LIMIT (Ea accident) $ BODI LY INJ U RY(Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ $ UMBRELLA LAB EXCESS ILIA B OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DEDUCTIBLE RETENTION $ $ $ A WORKERSCOMPENSATION AND EMPLOYERTIJABILITY YIN ANY OFFICER/MEMBEREXCLNER/E ECUTIVE❑ (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below NIA 40S440 INCL BLANKET WAIVER OF SUBROGATIO-NJ 04101/2012 04101/2013 X TORY LIAMITB OTH- E.L. EACH ACCIDENT $ 500,000 EL.DISEASE - EA EMPLOYEE $ 500,000 E.L. DISEASE - POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space is required) CERTIFICATE HOLDER CANCELLATION City of Fort Collins 700 Wood Street Fort Collins, CO 80521 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 ©1988.2009 ACORD ACORD 25 (2009109) The ACORD name and logo are registered marks of ACORD