HomeMy WebLinkAbout101137 PINKARD CONSTRUCTION - INSURANCE CERTIFICATE (2)PSIMI]YIX11
R
OR ® CERTIFICATE OF LIABILITY INSURANCE DATE IMMIDDIYYYYI
a ACORO 09/19/2013
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 N
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. p
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to I ^'
the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the
PRODUCER
INN, Inc. - Colorado Division
FAX
(WC, No):
1550 17th Street
MRES&
Suite 600
Denver, CO 80202
INSURER(S) AFFORDING COVERAGE
NMCF
INSURER A:
=CH MHOL INS CO
16535
INSURED
INSURERS:
PINNACOL ASSUR
01190
Pinkard Construction
O113
101137
INSURER C
9195 West Gth Avenue
INSURER D:
Lakewood, CO 80215
INSURERS:
INSURERF:
rnvro ArdFS
rFQTIFICATF MDf$RFQ- 35780049
RFVISIOM NUMRFR-
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR TYPE OF INSURANCE ADOLjSUBRi.
NUMBER POLICYEFF I POUCYEXP IN"LTR
_3
A GENERAL LIABILITY GL0931935601
11/01/1
11/01/13
EACH OCCURRENCE
f 1,000,000
X j
'COMMERCIAL
DAMAGE TO RENTED
3001 000
GENERAL LIABILITY I
PREMI6ES.D;a O$dYIlellLet_
S
CLAIMS -MADE 1 X (OCCUR
MEDEXP(AIIywMllano0)
$5,000
X $5, 000 Deductible
PERSONAL{ ADV INJURY
f_1,000,000
GENERAL AGGREGATE
$ 2,000,000
GEN'L AGGRLGATE LIMIT APPLIES PER:
PRODUCTS-COup"AGG
$2,000,000
POLICY X PRO,lFIT j LOG
A AUTOMOBILELIABILT'
'BAP931935501
1
1 OIF.MBI�EDSINGLEUMJT
f1000, 000
X .ANY AUTO
BODILY INJURY (Per pmson)
$
ALL DINED I ISCHEDULED
BODILY INJURY(P�+accideM)
f
AUTOS AUTOS
_
X HIRED AUTOS X �OSWNED
PROPERTY
Par amment) ____.
f
_
f.
A IX UMBRELLA UAII I = IOCCUR
AQC583W5100
11/O1/1
11/01/13
EACH OCCURRENCE_ $ 10,000,000
EXCESS LAO CLAIMS -MADE
AGGREGATE $10,000,000
_1
DED 'X 1� RETENTIONS 10, 000
$
S WORNERSCOMPENSATON
2321400 10/01/2
10/01/1{
V/CSTATIJ- Oil+
X UNITS ER
AND EMPLOYER9'Ll,t&CITY Yin
.THY _ _
ANY PROPRIETORIPARTNERIEXECUTIVE
11
NUA
EL EACH ACCIDENT $ 500,000
----- - - _ -- -- _
OFFICEFUMEMBER EXCLUDED?
(MandMary In NHl
j
:
E.L DISEASE- EA EMPLOYEE$ 50_0,000
E.L DISEASE -POLICY LMIT f 500, 000
n yyeeaa de T10"Nuncle,
DESCRIPTION OF OPERATIONS NIow
I
I
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES JANach ACORD 101, AddBlonM Ramarta 9chadVla, it man pace la nqulnd)
Certificate Holder is included as Additional Insured on the General Liability Policy if required by written contract or
agreement and with respect to work performed by Insured subject to the policy terms and Conditions. A waiver of
Holder on the General Liability and Workers Compensation Policies, if requried by written contract or agresment subject
to the policy terms and conditions.
conditions.
work Order# H-WRP.
-1 Deft Odor Control.
of Port Collins
west La Porte Ave.
BOX 580
Collins, CO 80522
ACORD 25 (2010/05)
ryan23
35780049
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
USA / /W
(0 1988-2010 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD
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