HomeMy WebLinkAbout262877 RTN ROOFING SYSTEMS LLC - INSURANCE CERTIFICATE (4)ROOFT-1 OP ID: CT
CERTIFICATE OF LIABILITY INSURANCE
oaT05/01/1405101114
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 WANED, 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 970-223-1804
VolkBell PropeM 8 Casualty
1100 Haxton Dr. uite #100
CONTACT
NAME:
PHONE FAX
ac No Est). uc Na
Fort Collins, CO 80525
Steven G. Smith /Y �r
EMAIL
ADDRESS:
INSURER(S) AFFORDING COVERAGE
NAICS
INSURER A: CNA Insurance Companies
20427
INSURED RTN Roofing Systems, LLC
5854 Lockheed Ave.
INSURER B:
—'
Loveland, CO 80538
INSURERC:
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
LTR
OF INSURANCE
L
kDDTYPE
R
POLICY NUMBER
MMIDDfYTf POLICY EFF
MMIDDY EXP
LIMITS
A
GENERAL LIABILITY
X COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE FXI OCCUR
X
5084284015 -
05/01/14
05/01/15
EACH OCCURRENCE
E 1,000,00
PREMISES Ea occurrence
$ 100,00
MED EXP(Anyone person)
$ 5,00
PERSONAL S ADV INJURY
$ 1,000,00
GENERAL AGGREGATE
$ 2,000,00
GEN'L AGGREGATE LIMIT APPLIES PER:
POLICY X JECP'OLOC
PRODUCTS - COMP/OP AGO
$ 2,000,000
$
A
AUTOMOBILE
LIABILITY
ANY AUTO
ALL OWNED SCHEDULED
AUTOS AUTOS
NON WNED
HIRED AUTOS N AUTOS
X
5084284015
05/01/14
05/01/15
COMBINED SINGLE LIMIT
8 1,000,000
X
Ssoadeni
BODILY IWURY(Per person)
$
BODILY INJURY (Per ecadent)
$
X
PROPERTY DAMAGE
Per amdent
$
E
A
J(
UMBRELLALIAB
EXCESS LIAR
X
OCCUR
CI-XMS-MADE
4030407376
05/01/14
05/01/15
EACH OCCURRENCE
S 1,000,00
AGGREGATE
$
OED X RETENTIONE
$
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY YIN
ANY PROPRIETORIPARTNEMEXECUTNE ❑
OFFICER EMBER EXCLUDEDT
(Mandatory In NH)
If yes, describe antler
DESCRIPTION OF OPERATIONS below
N / A
WC STATU- OTH-
T RY LIMIT R
E.L. EACH ACCIDENT
$
E.L. DISEASE - EA EMPLOYE
$
E.L. DISEASE -POLICY LIMIT
$
A
Inland Marine
5084284015
05/01/14
05/01/15
Inst Fit 25,000
DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (Attach ACORD 101, Addkonal Remake Schedule, If more space Is mqulred)
The City of Ft. Collins is listed as an Additional Insured with regards to
the General and Auto Liabiity policy(s).
City of Fort Collins
Purchasing Division
215 N. Mason St 2nd Floor
P.O. Box 580
,Ft. Collins, CO 80522-0580
CITYF-1
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 REPRESENTAT WE
C 1988-2010 ACORD
ACORD 25 (2010/05)
The ACORD name and logo are registered marks of ACORD
reserved.