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Home My WebLink AboutBOULDER ROOFING INC - INSURANCE CERTIFICATEtk. R CERTIFICATE OF LIABILITY INSURANCE � D DD/YYYV) 3/20/20/2014 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 Christine Walker, CISR NAME: Moody Insurance Agency, Inc. East Tufts Avenue PHONE . (303) 824-6600 FyAXc kill, (303)370-011$ Ad�8055 ML�ss.christine.walker@mooTyins.com Suite 1000 INSURERS AFFORDING COVERAGE NAIL# INSURER A:Plnnacol Assurance 41190 Denver CO 80237 INSURED INSURER B : Boulder Roofing, Inc. INSURERC: INSURER D: 3551 Pearl St INSURER E: Boulder CO 80301 INSURER F: COVERAGES CERTIFICATE NUMBER:14-1S WC 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. ILTR TYPE OF INSURANCE ADDL SUM POLICY NUMBER POLICY EFF Y POLICY EXP LIMITS GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY CLAIMS -MADE DOCCUR EACH OCCURRENCE $ ES (Ea xT PREMISES rr $ MED EXP (Any one arson E PERSONAL &ADV INJURY $ GENERAL AGGREGATE S GEN'L AGGREGATE 17 POLICY LIMIT APPLIES PER 7 PRO- LOC PRODUCTS -COMPIOP AGG $ E AUTOMOBILE LIABILITY ANY AUTO ALLOWNED SCHEDAUTOS HIRED AUTOS NON -OWNED AUTOS COMBINED SING UMIT BODILY INJURY (Per person) $ BODILY BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per sec' n $ E UMBRELLA LIAR EXCESS LIAR OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DED I I RETENTION $ A WORKERS COMPENSATION ANDEMPLOYERS'UABILITY YIN ANY PROPRIETOWPARTNERIEXECUTIVE OFFICENMEMBER EXCLUDED? (Mandatory in NH) I/ yes. describe under DESCRIPTION OF OPERATIONS below NIA 058510 /1/2016 /1/ZO35 x I WCSTATU- OTH- E.L. EACH ACCIDENT S 100,000 E.L. DISEASE - EA EMPLOYEd $ 100,000 E.L. DISEASE -POLICY LIMIT 1 $ 500,000 7 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Ans ch ACORD 101. Additional Remarks Schedule, it more space is required) City of Fort Collins P.O. Box 580 Fort Collins, CO 80500 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DEUVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ACORD 25 (2010/05) Walker, CISR/CHRWAL 01 INS025 (2oiom5 .o1 The ACORD name and logo are registered marks of ACORD All riahts reserved.