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HomeMy WebLinkAboutTOMASINI CONSTRUCTION - INSURANCE CERTIFICATETOMAS-2 OP ID: BA 1 AcoRO" CERTIFICATE OF LIABILITY INSURANCE DATE 01/31/2 Y013 01/31/23 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 ,CONTACT Phone: 970-635-9400 PFS Insurance Group -JT Fax: 970-635-9401 4848 Thompson Pkwy, Ste 200INC, Johnstown, CO 80534 _ _ _ Johnstown'Select-Accounts--" '-"-"-"""- -""--'--- .. NAME, - PHONE FAX No Eal): No:. E MAILss: - _ V INSURER(S)AFFORDING COVERAGE NAICp INSURERA: Builders Insurance Group ' INSURED �Tomaslnl Inc. INSURER B: INSURER C: dba Tomasini Construction Tomasini Construction 4210 Eagle Lake S. INSURER D: Fort Collins, CO 80524 INSURER E: INSURER F : COVERAGES CFRTIFICATF 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. INSR LTR TYPE OF INSURANCE ADDL UBR POLICY NUMBER POLICY EFF MMIDD,YYYY POLICY EXP MMIDDIYYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 A X COMMERCIAL GENERAL LIABILITY GLP011948200 01/29/2013 01/29/2014 DAN17ME70 RENTED PREMISES Ea occurrence) $ 100,00 MED EXP(Any one per son) $ 5,88 CLAIMS -MADE I OCCUR PERSONAL B ADV INJURY S 1,000,00 GENERAL AGGREGATE $ 2,DDD,OD GEN'L AGGREGATE LIMIT APPLIES PER'. - PRODUCTS - COMPIOP AGG $s 2,000,00 $ X POLICY ,. PRO- LOG AUTOMOBILELIABILITY ANYAUTOP-r"-`u. - - „',, - COMBINED SINGLE LIMIT--- Ea accident - - - - $ BODILY INJURV(Per Person)' 8 -- - - BODILY INJURY accident) $ -- - --" --' ALL OWNED SCHEDULED AUTOS.NON-OWNED: '.,: HIRED AUTOS .AUTOS .� r r """ ' - - -"' _.. -" -. .-- .._ .. _ - _ ,- _.. - - - --.._ - PROPERTY DAMAGE_ Per accident $ UMBRELLA LIAB OCCUR .. -- "-'- EACH OCCURRENCE 8 AGGREGATE $ EXCESS LIAB CLAIMS -MADE DED I I RETENTION$ $ WORKERS COMPENSATION ANDEMPLOYERTUABILITY '_YJN- ANY PROPRIETORIPARTNERIEXECUTIVE OFFICER/MEMBER E%CLUDED? 71 (Mandatory in NH) NIA - - -_. _- WC STATU- OTH- T RV LIMITS ER. E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ E.L. DSEASE-POLICY LIMIT $ If yes, describe under DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space Is required) Carpentry/All Locations/ All Operations CFRTIFICATF HOI DFR CANCELLATION CITYOFC SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of Fort Collins Purchasing Division 2nd Floor AUTHORIZED REPRESENTATIVE 215 North Mason Street (Fort Collins CO 80524 © 1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD