The URL can be used to link to this page

Home My WebLink AboutMPB CONTRACTORS - INSURANCE CERTIFICATE (2)ACO p�® Ill l_ A CERTIFICATE OF LIABILITY INSURANCE DATE (MWDDIYYYY) 2i5/2014 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: PHONE FAX fAJCNo Ext) - - A/C No : - - Olson & Olson Ltd 5655 S Yosemite St. #101 Greenwood Village CO 80111 E-MAIL ADDRESS. INSURERS AFFORDING COVERAGE NAIC 0 INSURER A:Westfield Insurance Company 24112 INSURED MPBC0-1 INSURER B: INSURER C: MPB Contractors 3155 Chambers Road Aurora CO 80011 INSURER D: E -INSURER INSURER F : COVERAGES CERTIFICATE NUMBER:5531A79RA 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. NOTWTHSTANDING 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 rypE OF INSURANCE ADOLSUBRI INSR WV POLICY NUMBER POLICY EFF MM/DD/VYYY POLICY EXP MMIDD LIMITS A GENERAL LIABILITY rRA5122432 12014 1/2015 EACH OCCURRENCE $1,000,000 X COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence) $500,000 CLAIMS -MADE IT] OCCUR MED EXP (Any oneperson) $15 000 PERSONAL &ADV INJURY $1,000,000 GENERAL AGGREGATE $2000 000 GENT AGGREGATE LIMIT APPLIES PER. PRODUCTS-COMP/OPAGG $2000000 $ POLICY PR6 LOC A AUTOMOBILE LIABILITY TRA5122432 12014 12015 COMEa amident SINGLENED .000 000 BODILY INJURY (Per Person) $ X ANY AUTO BODILY INJURY (Per accident) $ ALL OWNED SCHEDULED AUTOS AUTOS PROPERTYPaDAMAGE $ NON -OWNED HIREDAUTOS AUTOS $ A UMBRELLA LIAR X OCCUR TRA5122432 /12014 12015 EACH OCCURRENCE $5,000,000 AGGREGATE S5,000,000 EXCESS LAB CLAIMS -MADE DELI I X I RETENTION$NIL $ B WORKERS COMPENSATION 4058803 /12013 /12014 X WC STATLIMU- OTH- FR AND EMPLOYERS' UABIUTY ANY PROPRIETOR/PARTNER/EXECUTIVE YIN OFFICER/MEMBER EXCLUDED? (Mandatory In NH) N / A E.L. EACH ACCIDENT $500,000 E.L. DISEASE - EA EMPLOYEE $500 000 E L DISEASE- POLICY LIMIT $5OO 000 If yes, describe under DESCRIPTION OF OPERATIONS below A Installation Floater RA5122432 12014 12015 Building $1,000,000 Deduct $1,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more apace is required) Certificate Holder and those listed below(if any) are Additional Insureds as respects General Liability and Umbrella Liability on a Primary and Non -Contributory basis, and Auto Liability only if required by written contract or agreement and coverage applies only as respects work performed by the Insured for the Additional Insureds. All coverage terms, conditions, and exclusions of the policy apply. The Worker's Compensation, General Liability, Auto Liability, and Umbrella Liability policies include a Waiver of Subrogation in favor of the Additional Insureds only if required by written contract or agreement. Contractor's License. L:th( I It -ILA I t MULUCK t.AIVI.CLLA I IUIV City of Fort Collins P ,O. Box 580 Fort Collins CO 80522-0580 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 (c) 1`.)t1I%-ZU1U AL L)KU L UKI'V A I IUIV. An ngnls reserveu. ACORD 25 (2010I05) The ACORD name and logo are registered marks of ACORD