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Home My WebLink AboutFARQUHAR MASONRY - INSURANCE CERTIFICATE (3)FAROU-1 OP ID: BA ,a►�� CERTIFICATE OF LIABILITY INSURANCE DATE 312014Y) OS/13I2014 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 PFS Insurance Group -JT 4848 Thompson Pkwy, Ste 200 CONTACT NAME: PHONE FAX INC. No Ert : AIC No): Johnstown, CO 80534 Johnstown Select Accounts E-MAIL ADDRESS: INSURERIS AFFORDING COVERAGE NAICN INSURER A: Plnnacol Assurance Co 41190 INSURED Farquhar Masonry Peter Farquhar 900 W. Prospect Rd. INSURER B:Hartford Insurance Co. 29424 INSURER C: Ft. Collins, CO 80526 INSURER D: INSURER E INSURER F COVERAGES CERTIFICATE NUMBER: 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. INSR TYPE OF INSURANCE AND SUB POLICY EFF POLICY EXP LTR POLICY NUMBER MMIDDIYYYY MWDDIYYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 B X COMMERCIAL GENERAL LIABILITY CLAIMSlMADE a OCCUR 34SBAPJ8108 06/06/2014 06/06/2015 AMA RENT PREMISES ERoccurrence)E_NTEO_ $ 100,00 MED EXP (Any one person) $ 10,00 PERSONAL B ADV INJURY $ 1,000,00 GENERAL AGGREGATE $ 2,000,00 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMPIOP AGG $ 2,000,00 RO- LOC POLICY PFCT $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ BODILY INJURY (Per person) $ ANY AUTO NIA ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ NON -OWNED HIRED AUTOS AUTOS PROPERTY DAMAGE PER ACCIDENT $ UMBRELLA LAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LAB CLAIMS -MADE N/A DED I I RETENTION$ $ WORKERS COMPENSATION WC STATU- OTH- A AND EMPLOYERS' LIABILITY ANY PROPRIETORIPARTNERIEXECUTIVE Y/N OFFICERIMEMBER EXLLUOED? NIA 4079677 04/01/2014 04/01/2015 TORY NIT E E.L. EACH ACCIDENT $ 500,00 E. L. DI SEASE-EA EMPLOYEE $ 500,00 (Mandatory In NH) UseNy describe unear , Of OPERATIONS delaw E.L. DISEASE - POLICY LIMIT $ 500,00 B Installation 34SBAPJ8108 06/06/2014 06/06/2015 Install. 20,00 Floater Floater DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space is required) Project: Parking Permit If required by written contract or written agreement, the certificate holder is included as additional insured for ongoing operations under general liability. CTYFTCI City of Fort Collins Front Desk 215 N. Mason Street 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. AUTHORIZED REPRESENTATIVE 1988.2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD