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HomeMy WebLinkAboutPETERICH CUSTOM CONSTRUCTION INC - INSURANCE CERTIFICATEACORO® CERTIFICATE OF LIABILITY INSURANCE bATE(MMloonvrv) L.� OS/19/2014 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: R the certificate holder is an ADDITIONAL INSURED, the policy(les) must be endorsed. It 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 center rights to the certificate holder In Reu of such endoroement(s). PRODUCEa Talren J. Quarn_ Mountain Plelns Agency, LLC P FUC.NeI 4532 McMury Ave D_ NL Iran@mnlmtainnla'neacenry non Suite 150 INSURE 9f AFFORDNG COaRAGE NAICa Fort Collins CO_ 80525 elsu , referred Contractors Insurance Company, RRG INSURED Dan Peterich alp NSURERC DBA: Peledch Custom Construction, Inc. wsuRER D: 6005 Bluespnuce Dr RER E: Bellvue CO 80512 uuvc ueb CERTIFICATF NtIMRFR• ¢MmnM uuu¢cv- 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, TFiE 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. ILTRNSR TYPE OFIN$UIGMCE LJIM POLIC MBER POLICY UP .POLICY FJIP. 111 10/01/2014 UMR9 A GENERALLIABLLITY JC CONMERCW,GENERALLIAHUTYrrPRE6J CLAOVS-WE Q OCCUR _ 1 _, .l PC90931 ') 101012013 EACH OCCURRENCE f 100 0000 NTED AEDEXP("One m) f 5000 f 5000 PERsoNAL&ADv WuRv f 10MODO GENERAL AGGREGATE S 2000000 GENt AGGREGI1Te hX Pouc UMm APRIES PER: PR ' LOC PRODUCTS. COMP/OP ASS s2D00D00 s AUTOMOBILE LIABILITY ANYAUTO ALL 01MfE0 SCHEDULED AUTOS AUTOS NON HIRFU kIlOS AUTOS PIED r I EAPcdo i L Lear SWLYINANY(Fw DNson) f BODILY INJURY(PereeYi0m0 S PROPERTY DAM ,Pim' S f UMBRELLA LNB EXCESS LIAR OCCUR CW.MS-MAOEI IF-lu ) EACHOCCUiRENCE S AliOREGATE f oen RE1LMgN ,T WORNERSCOMPENSATION AND EMPLOYERS' WSILT ANY PROPPIWTOWARTNEREXECUnVE Y1N OFFICEMENBER E%CLLDEO? (Nandm¢y in*n RYes.N ..M nm. NIA �' TA - `O E.L. EACHACCIDENT f EL DISEASE -EA EMPLOYE _ .S El DISEASE -POLICY UMrr - S r DESCRIPTION Or OPFRA71ON6lLOCATION61 VEHICLES (AtLPOH ACORO tO1, AdOWOnPI Remake 8chedub, Rmen epPCP IP rnry1nM) Residential and Commercial roofing contractor. Artisan remodel Contractor. Both dwellings and structures. City of Fort Collins 281 N College Ave Fort Collins CO 80524 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISHMS: All ACORD 25 (2010105) The ACORD name and logo are registered markrikof ACORD