HomeMy WebLinkAboutHASELDEN CONSTRUCTION LLC - INSURANCE CERTIFICATEYS]IAUlNMIl
A� ® CERTIFICATE OF LIABILITY INSURANCE D06/28 DOrc4
o6ne/zo14
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(les) 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
PRODUCER
INA, Inc. - Colorado Diviaion
1705 17th Street
Suite 100
Denver, CO 80202
INSURED
Haselden Construction, LLC
6950 South Potoaac Street
Centennial. CO 80112
PHONE
FAX
INC. No. En):
IAn:, No):
EMAIL
AOORE
ADDRES3:
denpamPimacorp.com
INSURER(S) AFFORDING COVERAGE
INSURER A:
VALLEY FORCE INS CO (CNA)
INSURERS:
NATIONAL UNION FIRE INS CO OF
INSURER C:
PINNACOL ASSUR
INSURER D :
INSURER E :
COVFRAGFS CFRTIFICATF NI)MRFR- 40482148 RFVIRION NIIMRFR-
NAIC r
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.
IRi ADOOSURR
I MNIDYY LIMITS
TYPE OF INSURANCE I LTR NSRIwIml POLICY NUMBER MMO70IYTYY OIYY
A
GENERAL DABILITY
C40288OB411
07/01/14
07/01/15
EACH OCCURRENCE
S 1,000,000
Y
COMMERCIAL GENERAL LIABILITY
DAMAGE TO RENTED
PREMISES a=u rt
PREMISES
$ 500,000
7
CLAIMS -MADE 1 X I OCCUR
MED EXP(Any one parson)
$ 5,000
X PD Ded: 110,000
PERSONAL 8A0V INJURY
s1,000,000
GENERALAGGREGATE
S 2,000,000
is
GENE AGGREGATE LIMIT APPLIES PER:
PRODUCTS - COMPIOP AGG
2,000,000
I POLICY X I PR6 i X I LOG
_..
Is
A
AUTOMOBILE LIABILITY
C4028808425
07/01/1
; COMBINED �ISINGLE LIMIT
$ 1,000,000
X ANY AUTO
BODILY INJURY (Poe person)
$
ALLOWNED SCHEDULED
AUTOS AUTOS
BODILY INJURY (Pee ...dent)
$
NONOWNEDPROPERTY
DAMAGE
$
HIRED AUTOS AUTOS
_(Per accident)
iY IX
$
B
X
UNBRELLALIAS X (OCCUR
BE31131554
07/01/14
07/01/15
EACH OCCURRENCE
$ 2,000,000
EXCESS UAB ICLAIMS#UOE_
AGGREGATE
S2,000,000
MO IX 1 RETENTION$30,000
,
S
WORKERS COMPENSATION
14082635 - CO ONLY
07/01/14
07/01/15
WC STATU} I OTH.
xI TORY LIMITS( ER
AND EMPLOYERS' LIABILITYC YIN
ANY PROPRIETORRMTNERIE %ECUTIVE
EL EACH ACCIDENT
$ 500, 000
OPFICERIMEMBER EXCLUDED? N❑
NIA
- -
(Wyyndaw,mNN)
E.L. DIS_EAS_E - EA EMPLOYE
$500, 000
(
DESCRI�ON OF OPERATIONS below
E.L. DISEASE-POLICYLIMIT
g500,000
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ANach ACORD 101, AddlUonal Romans Schedule, N mom apace Is required)
RE: Contractors License
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
Of Fort Collins THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
Box 580 AUTHORIZED REPRESENTATIVE /n/J
Fort Collur[ a/a, CO 80522-0580 /
USA �I/�
All dnHsa .n,:—A
ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD
SDZN
40482148