HomeMy WebLinkAboutCHRISTOFFERSON COMMERCIAL BLDR - INSURANCE CERTIFICATE30040
A�� �® CERTIFICATE OF LIABILITY INSURANCE
DATEn
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 endorsements).
PRODUCER
Commercial Lines - (719) 592-1177
Wells Fargo Insurance Services USA, Inc.
5755 Mark Cabling Blvd., Suite 300
CONTACT Amber Keller
NAME:
PHONE FAX
Exii. 800-332-9256
C10twe Nm: 877-0OS-9032
-AWLr
ADDRESS:
INSURERS AFFORDING COVERAGE
NAIC d
INSURERA: Continental Insurance Company
35289
Colorado Springs, CO 80919-2228
INSURED
Christofferson Commercial Bldr
INSURER B: American Casualty Company of Reading, PA
20427
Continental Casual C
msuRERc: Casualty Company P Y
20443
3235 Fillmore Ridge Heights
INSURERD: Pinnacol Assurance Company
41190
INSURERE: Texas Mutual Insurance Company
22945
INSURER F
Colorado Springs, CO 80907
COVERAGES CERTIFICATE NUMBER: 7631105 REVISION NUMBER: See below
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
IMsn
SUER
POLICY NUMBER
MPMO/LIDDY EFF
MM/DD E%P
LIMITS
q
X
COMMERCIAL GENERAL DABILRY
CLAIMS -MADE [K OCCUR
4029178419
04/24/2014
04/24/2015
EACH OCCURRENCE
DAMAGE TO RENTED
PREMISE_S(Ea pccunencel
$ 1.000,000
_
$ 300,000
$ 5,000
MED EXP (Any one Person)
PERSONAL &ADV INJURY
$ 1,00a,000
GENL
AGGREGATE LIMIT APPLIES PER:
GENERAL AGGREGATE
$ 2.000,000
POLICY PRO-
JECT �1
T u LOC
PRODUCTS-COMP/OP AGG
S 2.000.000
S
OTHER:
B
AUTOMOBILE
LIABILITY
4029178405
04/24/2014
04/24/2015
COMBINED SINGLE LIMIT
Ea ecdGen)___
$ 1,aaa wo
x
BODILY INJURY (Per person)
$
ANY AUTO
ALL OWNED SCHEDULED
AUTOS AUTOS
BODILY INJURY (Per accident)
S
x
PROPERTY DAMAGE
fear accident
$
NON -OWNED
HIRED AUTOS N AUTOS
f
C
UMBRELLA LUU1
x
OCCUR
L4017347948
04/24/2014
04/24/2015
EACH OCCURRENCE
S 2,000,000
x
AGGREGATE
S 2.000,000
EXCESS LIAR
CLAIMS#NDE
LIED x RETENTION 10,000
S
D
E
ANc MPLOYERS' LIABILITY YIN ON
ANY PROPRIETORIPARTNER/EXECUIVE
OFFICERIMEMBER EXCLUDED? N
(Mandatory In NH)
NIA
4042537 (CO)
SBP00012644102 0140201(TX
02/01/2014
02/01/2014
02/01/2015
02/01/2015
X STALT.VTE ERA
E.L. EACH ACCIDENT
$ fODD,000
E.L. DISEASE - EA EMPLOYEE
$ 10m,000
I/Tea, desuiDe under
DESCRIPTION OF OPERATIONS below
E.L. DISEASE - POLICY LIMIT
$ 1.000 ,000
A
Contractor's Equipment
4029178419
04/24/2014
04/24/2015
100.000 Lease URented Equipment, max value per item
DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Addit oral Remarks Schedule, may he aftachad If me. space Is required)
Certificate of Insurance
City of Fort Collins
281 N College Ave
PO Box 580
Fort Collins CO 80522
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
97--4-/-
The ACORD name and loco are registered marks of ACORD 01988-2014 ACORD CORPORATION. All rights
ACORD 25 (2014101) 111111111111111111111111111111111IN I11111111111111111111111111111111111111111111111111111 �.a�