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HomeMy WebLinkAbout480487 RISING SUN FENCE & CONSTRUCTION LLC - INSURANCE CERTIFICATE (4)ACOR" CERTIFICATE OF LIABILITY INSURANCE `, OATE(MM/DDIYYYY) 01/04/2013 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). PRODUCECONTACT R NAME: Diane E. Martin Timberline Insurance Agency, Inc. PNDNE 307-637-4757 307-637-4266 A/C No : AIG, No ADDRESS:Ext demartin@timberlineins.com P. O. Box 20007 INSURER(S) AFFORDING COVERAGE NAIC R Cheyenne, WY 82003 I' Lm 4- INSURER A: Scottsdale Insurance Company INSURED INSURER 8 Rising Sun Fence & Construction, LLC INSURER C: 1274 Cole Road INSURER D : Cheyenne, WY 82009 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. LTR TYPE OF INSURANCE INSR NND POLICY NUMBER MMIDD/YYYY MMIDD/YYYY LIMRS A GENERAL LIABILITY CO MMERCIAL GENERAL LIABILITY CLAIMS -MADE FAOCCUR X CPS1547489 04/14/2012 04/14/2013 EACH OCCURRENCE $ 1,000,000 PREMISES Ea occurrence $ 100,000 MED EXP (Any one person) $ 5,000 PERSONAL S ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: ro POLICY PRO- JECT OC PRODUCTS - COMP/OP AGG $ 2,000,000 $ AUTOMOBILE LIABILIT ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS HIRED AUTOS NON -OWNED AUTOS UUMUINLU (Ea accident $ BODILY INJURY (Per person) $ BODILY INJURY Per accident $ Per accident $ UMBRELLA LIAR EXCESS LIAR OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DIED I I RETENTIONS $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETORrPARTNER/EXECUTIVE[::] OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below NIA A I WC 5TATU- OTH- TORY LIMITS ER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYE $ E.L. DISEASE - POLICY LIMI $ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) Fencing Contractor Additional Insured Status when required by contract form CG 203307 04 applies to the certificate holder. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Fort Collins THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Attn: Purchasing ACCORDANCE WITH THE POLICY PROVISIONS. P.O. Box 580 AUTHORIZED REPRE TATIVE Fort Collins, CO 80522 Fax 970 221-6707 Uut Diane E. Martin '//AiwL nWA 25 (2010/05) ©1988.2010 ACORD CORPORATION. All The ACORD name and logo are registered marks of ACORD