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Home My WebLink About133159 PAUL DAVIS RESTORATION OF NORTHERN COLORADO - INSURANCE CERTIFICATE (3)PAULD-4 OP ID: SF ,d►CORO' CERTIFICATE OF LIABILITY INSURANCE ATE os/zana D06/2412 Vot4 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 PFS Insurance Group -JT 4848 Thompson Pkwy, Ste 200 CONTACT Jeramie Holt PHONE FAX A/c No Est :970-635-9400 AIc No : 970-635-9401 Johnstown, CO 80534 Jeramie Holt EMAIL ADDRESS: INSURER(S) AFFORDING COVERAGE NAICk INSURER A: Allied Insurance Group 19100 INSURED Legacy Corporation Paul Davis Restoration of Northern Colorado INSURERS: Everest Indemnity Ins. Company NsuRERc: Pinnacol Assurance Co 41190 309 Lincoln Court INSURER D: INSURER E: Fort Collins, CO 80524 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 LTR TYPE OF INSURANCEADDL SUBS POLICY NUMBER POLICY EFF MMIDDIYYYYI POLICY EXP (MMIDDIYYYYI LIMITS B X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR EF4ML05315141 07/01/2014 07/01/2015 EACH OCCURRENCE $ 1,000,00 PR MISES Ea occurrence $ 50,00 X MED EXP (Any one person) $ 5,00 Blkt AI X BIkt WOS PERSONAL B ADV INJURY $ 1,000,00 GEN L AGGREGATE LIMIT APPLIES PER: POLICY JECOT LOC GENERAL AGGREGATE $ 3,000,00 PRODUCTS - COMP/OP AGG $ 3,000,OO $ OTHER. AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident IS 1,000,00 X BODILY INJURY (Par person) $ A ANY AUTO ACP3006672462 07/01/2014 07/01/2015 ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY Per accident ( ) $ NON -OWNED HIRED AUTOS AUTOS PROPERTY DAMAGE Per accident $ X $ BIkt AI X BIkt WOS X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 2,000,0010 AGGREGATE $ 2,000,00 B EXCESS LIAB CLAIMS -MADE EF4C000657141 07/01/2014 07/01/2015 DED I X I RETENTION$ 10,000 $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/E%ECUTIVE YIN OFFICERIMEMBER EXCLUDEIE ❑ N I A 4156670 07/01/2014 07/01/2015 PER OTH- X STATUTE X ER EL EACH ACCIDENT $ 1,000,00 E. L. DISEASE - EA EMPLOYEE $ 1,000,00 (Mandatory in NH) If yes, describe under DESCRIPTION OF( below E.L DISEASE -POLICY LIMIT $ 1,000,00 A Property ACP3006672462 07/01/2014 07/01/2015 BPP 35,04 A Equipment Floater ACP3006672462 07/01/2014 07/01/2015 Leased/Re 100,00 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) If required by written agreement, the certificate holder is included as additional insured for ongoing operations under general liability. CITYFCI City of Fort Collins P.O. 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. AUTHORIZED REPRESENTATIVE 4 U 1UBB-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD