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HomeMy WebLinkAbout201461 CONSTRUCTION CONCEPTS INC - INSURANCE CERTIFICATEr 'M L`Fn3 T CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDNYYY) 09/28/201Z 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: Karole Peters Ewing -Leavitt Insurance Agency a°N EX1:970.679.7355 iac.Ng1:866.237.2178 4025 St. Cloud Dr. ADDRESS: karole-peters@leavitt.com Suite 100 PRODUCER 00008432 CUSTOMERIDN: Loveland, CO 80538 INSURER(S) AFFORDING COVERAGE NAICN INSURED INSURER A: Cincinnati Insurance Co Construction Concepts Inc INSURER : PTnnacol Assurance 41190 1412S Mead Street INSURER : OneBeacon Insurance Company 21970 Longmont, CO 80504 INSURER D: 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 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 INSURANCE ADDL INSR SUBR WVD POLICY NUMBER POLICY EFF MMIDDYYY POLICY EXPIY MMIDONM LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE LA_] OCCUR )F Blkt Addl Insured CPP10911721010112012 10/01/2013 EACHOCCURRENCE $ 1,000,000 OHMAGERENTED PREMISESS ( Ea occurrence) $ SOO, OOO MED EXP(Any one person) $ 10,00 PERSONAL &ADV INJURY $ 1,000,00 X Blkt Waiver of Sub GENERAL AGGREGATE $ 2,000,00 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY nX ECT LOC PRODUCTS-COMPIOPAGG $ 2,000,00 $ A AUTOMOBILE LIABILITY ANY AUTO ALLOWNEDAUTOS SCHEDULED AUTOS HIREDAUTOS NON -OWNED AUTOS CPP1091172.10101I2012 10/01/2013 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 X BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ X X $ $ A J( UMBRELLALIAB EXCESS LIAB X OCCUR CLAIMS -MADE CPPI0911721010112012 10/01/2013 EACH OCCURRENCE $ 2,000,00 AGGREGATE $ 2,000,00 DEDUCTIBLE D RETENTION $WORKERS $ X $ B COMPENSATION AND EMPLOYERS' LIABILITY y I N ANY PROPRIETOR/PARTNERIEXECUTIVE OFFICERIMEMBER EXCLUDED? (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below N I A 40317450710112012 BLANKET WAIVE OF SUBROGATIO 0710112013 X ORY uMiUS ER E. L. EACH ACCIDENT $ 1, 000, 00 00 E.L. DISEASE -EA EMPLOYEE $ 1,000,00 E.L. DISEASE -POLICY LIMIT $ 1,000,000 C Commercial Builders Risk Reporting Form 7900103051010112012 10/0112013 $1,500,000 Any One Structure $1,000 Deductible DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space Is required) CERTIFICATE HOLDER CANCELLATION City of Fort Collins Purchasing Division 215 N. Mason Street 2nd Floor 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 K Karole Peters/KAPE' © 1988-2009 ACORD 25 (2009109) The ACORD name and logo are registered marks of ACORD