HomeMy WebLinkAbout165981 SAILER CONSTRUCTION OF FORT COLLINS INC - INSURANCE CERTIFICATESAILE-2 OP ID: PL
,d►141 CERTIFICATE OF LIABILITY INSURANCE
DATD/YYYY)
05125
05125112
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 ' v 970-635-9400
PFSlnsurance Group -JT 970-635-9401
4848 Thompson Pkwy,.Ste 200'-•
CONTACT
NAME: -
PHONE FAX
AIc No J: -, ac Na:
E-MAIL
ADDRESS:
Johnstown; CO 80534
Johnstown Select Accounts
INSURERS AFFORDING COVERAGE NAICp
.0j-.�'—•'-'V
INSURER A : Darwin Select Insurance Cc
INSURED Sailer Construction of
Ft. Collins, Inc
5318 Highcastle Drive
INSURER B:
INSURER C:
Ft Collins, CO 80525.6714
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 15 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
AD
BR
POLICY NUMBER
POLICY EFF
MMIDDIYYYY
POLICY EXP
MMIDD/YYYY
LIMITS
GENERAL LIABILITY
EACH OCCURRENCE
$ 1,000,00C
COMMERCIAL GENERAL LIABILITY
03066230
04/18/12
04/18/13
DAfAGE77"
PREMISES (Eaoccurrenca)
$
MED EXP (Any one person)
Is
CLAIMS -MADE OCCUR
A
X
CONTINGENT BODILY INJURY
PERSONAL& AOV INJURY
I$
GENERAL AGGREGATE
I $
.AND PROPERTY DAMAGE
GENL AGGREGATE LIMIT APPLIES PER
PRODUCTS-COMP/OPAGG
S
POLICY PRO- IFCT n LOC
$'- -
AUTOMOBILE
LIABILITY
1..
COMBINED SINGLE LIMIT
Ea aCeitlenl
$
BODILY INJURY (Per person)]
'$ -
ANVAUTO'�"
-
--
ALL OWNED,":� SCHEDULED
AUTOS. AUTOS
(�
'
BODILY INJURY Per accident)
$
•
NON -OWNED
•HIRED AUTOS _ AUTOS -
..
--. _... _ --. _ . -
- -
- - -
r
PROPERTY DAMAGE
Peramidenl -
$ - .. -._..
UMBRELLA LIAS
OCCUR
-
EACH OCCURRENCE
$
AGGREGATE
$
EXCESS LIAR
CLAIMS -MADE
DED RETENTION $
$
WORKERS COMPENSATION
WC STATU- OTH-
AND EMPLOYERS' LIABILITY YIN
ANY PROPRIETORIPARTNERIEXECUTIVE
ER EXCLUDED'
OFFICEtor, ❑
NIA
-
T RY IMIT - R
E.L. EACH ACCIDENT
E.L. DISEASE - EA EMPLOYEE
$
In
If be and NH)
ns describe
GyeCRIPTIbe under
DESCRIPTION OF OPERATIONS below
E.L DISEASE -POLICY LIMIT
$ '
A
Professional Liab
03066230
04/28/12
04/28/13
Prof Liab -. 1,000,00
Ded. 1,00
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more apace Is required)
Construction Consulting/Contingent Bodily Injury and Property Damage
included in Professional Liability policy provisions
City of Fort Collins
215 North Mason St.,
Fort Collins, CO 80524
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 1988.2010 ACORD CORPORATION. All rights reserved.
ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD