HomeMy WebLinkAbout441491 ALPINE DEMOLITION - INSURANCE CERTIFICATEA� La CERTIFICATE OF LIABILITY INSURANCE
DATE 012012 Y)
04/30/2012
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 Phone: (303) 972-6633 Fax: (303)9➢2E655
IRG - AFFINITY INSURANCE PARTNERS, LLC
7991 SHAFFER PARKWAY, SUITE 300
LITTLETON CO 80127
CONTACT Danielle
PHONENo F.I, (303) 972-6633 Fax (303) 972.6655
F-MAIL dschmelingirgco.com
PRODUCERCLSTOMERD 24779
INSURER(S) AFFORDING COVERAGE
NAICN
INSURED
ALPINE DEMOLITION
5790 WEST 56TH AVENUE
ARVADA CO 80002
INSURERA Pmnacol Assurance
INSURER
INSURER
INSURER D'.
NSURER S
INSURERF
COVERAGES CERTIFICATE NUMBER: 39175 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,
FXCi HSIONS AND CONDITIONS OF SU i MITS SHOWN MAY HAVE PIPPIA PPnI IrPn RY Pain
Irv6R ITR TYPE OF INSURANCE ADD'L SUER POLICY NUMBER POLICY EFF POMCYEXP LIMITS
GENERAL LIABILITY
COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE 17 OCCUR
EACH OCCURRENCE
DAMAGE TO -RENTED
MED. EXP(Any one person)
_ PERSONAL 8 ADV INJURY
'AGG
�_
NIT
person)
Iccidenl)
$
$
$
$
GEN'L AGGREGATE LIMIT APPLIES PER:
POLICY — PRO- LOC
"rT/
$
$
AUTOMOBILE
LIABILITY
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIREDAUTOS
NON-0W NED AUTOS
$
$
$
$
$
UMBRELLA LIAR
EXCESS LIAB
OCCUR
CLAIMS WIDE
I
EACH OCCURRENCE
$
AGGREGATE
$
DEDUCTIBLE
RETENTION $
$
$
A
wORRERS COMPENSATION
AND EMPLOYERS' LIABILITY YIN
ANY PROPRIETORIPARTNERIEXECUTIVE
OFFICERIMEMSER EXCLUDED?
LMandam,y In NHl
II yee, do`7' a roper
DESCRIPTION OF OPERATIONS Le I—
NIA
4000961
05/01/12
05/01/13
X we STATU- orH
$
E.L. EACH ACCIDENT
$ 1,000,000
E.L. DISEASE -EA EMPLOYEE
$ 1,000,000
E.L. DISEASE -POLICY LIMIT
$ 1,000,000
DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required)
CEKIII ICAIE HOLDER CANCELLATION
City of Fort Collins SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
215 NOrth Mason Street THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
Fort Collins, Co. 80524 ACCORDANCE WITH THE POLICY PROVISIONS.
I AUTNOR12ED REPRESENTATIVE
Attention:
`:!5 John W. T— e—�
rights re;
The ACORD name and logo are registered marks of ACORD