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Home My WebLink About262877 RTN ROOFING SYSTEMS LLC - INSURANCE CERTIFICATE (3)A /%^i3n """1"0" CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYY) 03/07/2013 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 INSURERS), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policyfes) 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 endomement(s). PRODUCER CONTACT NAME' Renee McReynolds Ewing -Leavitt Insurance Agency 4025 St. Cloud Dr. jaCONe,EXt:970.679.7344 1a Ne),866.425.6180 nomiesS: renee-mcreynolds@leavitt.com Suite 100 Loveland, CO 80538 PRODUCER 00008600 CUSTOMER ID it, INSURER(S) AFFORDING COVERAGE NAIC If INSURED INSURER A: Pinnacol Assurance 141190 RTN Roofing Systems, LLC INSURER B: 5854 Lockheed Ave INSURER C: Loveland, CO 80538 INSURER D: INSURER E : INSURER F: COVERAGES CERTIFICATE NUMBER: 13-14 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 CONTRACTOR 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 MM/DD/YYVV POLICY EXP MM/00/YYYY LIMITS GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR EACH OCCURRENCE It DAMAGE TO RENTED PREMISES Ea occurrence $ MED EXP(Any one person) $ PERSONAL S ADV INJURY $ GENERAL AGGREGATE $ GENIE AGGREGATE LIMIT APPLIES PER: PoLICV FI JECOT n LOC PRODUCTS - COMP/OP AGG $ $ AUTOMOBILE LIABILITY ANY AUTO ALL OW NED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident)$ $ UMBRELLA UAB EXCESS LIAB OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DEDUCTIBLE RETENTION $ $ $ A AND EMPLOYERS'WORKERS LIABILIITY SATION y/N OFFICERIMEMBER EXCLUDEDI ANY PROPIRIETORIPARTNERIEXECUTIVE❑ (Mandate, In NH) If DESCRIPTIbe under ON OF OPERATIONS Oelow N / A cc�I 4054401 INCL BLANKET WAIVER OF SUBROGATOOl 04/01/2073 04/01/2014 X TpRV LIMITS ER E.L. EACH ACCIDENT $ 500,000 EL DISEASEEAEMPLOYEE $ 500,00 E.L. DISEASE- POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is required) 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 700 Wood Street Fort Collins, CO 80521 All riahts reserved ACORD 25 (2009/09) The ACORD name and logo are registered marks of ACORD