HomeMy WebLinkAboutBOONE PLUMBING LLC - INSURANCE CERTIFICATEBOONE-1 OP ID: P6
,a►`oao° CERTIFICATE OF LIABILITY INSURANCE
DATD/YYYYI
08108114
08108
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 Phone: 970-482-7747
Brown 8. Brown Inc Fax: 970-484-4165
4532 Boardwalk Dr, Suite 200
Fort Collins, CO 80525
House Account
CONTACT
NAME:
PHONE FAX
ac No EMI:INC, No:
EMAIL
ADDRESS:
INSURERS AFFORDING COVERAGE
NAIC d
INSURERA:United Fire 8: Casualty Co.
13021
INSURED Boone Plumbing, LLC
Michael J. Smith
INSURER B: Owners Insurance Company
32700
P.O. Box 889
INSURERC:
INSURER D:
Wellington, CO 80549
INSURER E :
INSURER F :
COVERAGES CERTIFICATE NUMBER: REV!SlnN 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
POLICY NUMBER
POLICY EFF
MM/DDNYYYI
POLICY EXP
(MMIDDNYYyJ
UNITS
GENERAL LIABILITY
EACH OCCURRENCE
$ 1,000,00
A
X COMMERCIAL GENERAL LIABILITY
FvI
CLAIMS MADE OCCUR
60370088
02/21/14
02/21/15
DAMA RENTED
PREMISES Ea o=rrence
$ 100,00
NED EXP(Any one person)
$ 5,0D
PERSONAL & ADV INJURY
S 1,000,00
GENERAL AGGREGATE
$ 2,000,00
GENT AGGREGATE LIMIT APPLIES PER:
PRODUCTS - COMP/OP AGG
$ 2,000,00
POLICY PRO LOD
S
MOBILELIABILITYCOMBINED
SINGLE LIMIT
S1,000,DDB
BODILY INJURY(Per person)
E
4649213300
09/08/14
09/08/16
LLOED X SCHEDULED
UTOAUTO$
FANYEAJTO
BODILY INJURY Per accident
( )IRDUTOS
S
NON -OWNED
AUTOS
PROPERTYDAMAGE
Per accident
$
E
UMBRELLA LIAB
OCCUR
EACH OCCURRENCE
$
AGGREGATE
$
EXCESS LU1B
CLAIMS -MADE
DIED I I RETENTION$
Is
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY YIN
ANY PROPRIETORRARTNER/EXECUTIVE
OFFICERNEMBER EXCLUDED?
NIA
WC STATU- OTH-
T RV R
E.L. EACH ACCIDENT
$
E.L. DISEASE - EA EMPLOYEE
$
[Mandatory In NH)
If yes, describe under
E.L. DISEASE - POLICY LIMIT
$
DESCRIPTION OF OPERATIONS below
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Addltlonal Remarks ScInedule, if mom space Is required)
FAX: 970-224-6134
CITYF11
City of Fort Collins
P 0 Box 5080
Fort Collins, CO 80622
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
S•G�L�e_
01988.2010 ACORD CORPORATION_ All rinhfa mm,...nd
ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD