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Home My WebLink AboutSTOCK BUILDING SUPPLY HOLDINGS INC - INSURANCE CERTIFICATE�® CERTIFICATE OF LIABILITY INSURANCE DATE(MMMWDDDDYY Y) O14 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 AOn Risk Insurance Services West, Inc. LDS Angeles CA Office 707,Wilshire Boulevard suite 2600 CONTACT NAME PHONE I,Exq; (866) 283-7122 No.)800-363-0105 E-MAIL _ ADDRIEu' INSURER(S) AFFORDING COVERAGE NAIC k LOS Angeles CIA 90017-0460 USA INSURED INSURERA: Zurich American Ins CO 16535 Stock BUildino SUDDIV HOldinDs. Inc. .-See Attached List of Named Insureds" 8020 Arco Corporate Drive INSURER B: American Zurich Ins CO 40142 INSURER( Liberty Insurance Corporation 42404 INSURER D: Raleigh NC 27617-2038 USA NSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 570053631247 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. Limbs shown are as requested LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER POLICY EFF MMIDDIyvYYI IPMMID LIMITS A X COMMERCIAL GENERAL LIABILITY GLO RRENCE $2,000,000 CLAIMS -MADE X❑ OCCUR AMA Ea occurrence $1,000,000 % ny one Person) $10, 0D0 Per LWProj. A99. $10M ADV INJURY MGENE�LA�REGATE $2,000,000 GEWL AGGREGATE LIMIT APPLIES PER GGREGATE $2,000,000 POLICY ❑JET ❑X LOC -COMPIOP AGO $4.000,000 OTHERA UTOMOBILE LIABILITY BAP 4783611 02 05/05/201405/05/ZO1$INGLE LIMIT Ire accident) $5, 000, DOD BODILY INJURY( Per person) % ANY AUTO ILY INJURY accident) ALL OWNED SCHEDULED AUTOS AUTOS X HIRED AUTOS X NON-0WNED AUTOS PERTY DAMAGE accident x $sWrc Ded/Per Ouu X SeM-mad Phys DM C % UMBRELIA LUU3 % OCCUR TH7661066229054 05/05/2014 OCCURRENCE $25,000,000 EXCESS LIAB CIAIMSMADE EGATE tE $25,000,000 DED % RETENTION f10, 000 B A WORKERS COMPENSATION AND EMPLOYERS'LIABIUTY YIN AN PROPRIETOR/ PARTNER OFFICER/MEMBER EXCLUDED9EXECIITIVE NIA WC478360902 All Other States WC583292202 05/05/2014 05/05/2014ACH PER OTH- STATUTE ACCIDENT $1, 000, 000 ISEASE-EA EMPLOYEE $1,000,000 (Mandatory in NH) WI Only I1y assorPs under DESCRIPTIONOF OPERATIONS below I E.L. DISEASE -POLICY LIMIT $1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Add'Nonal Remarks SeHedule, mry W alhched B more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS City of Fort Collins AUTHORIZED REPRESENTATNE Attn: Sandy Lindell P.O. Fort CollinsX 580 C CO 80522 USA �n ifl// A "Xii wwe J6ttaaa ,�,��„ JL 41 zij V Iq 01988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: 570000049655 _ LOC #: ADDITIONAL REMARKS SCHEDULE Page _ of AGENCY AonRisk-Insuranceservices-west,-`Inc. -" NAMED INSURED Stock Building Supply Holdings, Inc. POLICY NUMBER See Certificate Humber: 570053631247 CARRIER see Certificate Number: 570053631247 NAIC CODE EFFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: ACORD 25 FORM TITLE: Certificate of Liability Insurance SCHEDULE OF NAMED INSUREDS "SCHEDULE OF NAMED INSUREDS^ (applies to all policies unless noted below) stock Building Supply Holdings, Inc. f/k/a Saturn Acquisition Holdings, LLC Stock Building Supply, LLC Stock Building Supply Holdings, LLC Stock Building Supply Holdings II, LLC stock Building Supply west, LLC SBS/Bison Building Materials, LLC Stock Building supply west (USA), Inc. Michael Nicholas Carpentry, LLC Coleman Floor, LLC stock Building supply Midwest, LLC Stock Building Supply of Arkansas, LLC Stock Building Supply of Florida, LLC Coleman Floor Southeast, LLC TBSG, LLC Commonwealth Acquisition Holdings, LLC stock window & Door southeast, LLC The ACORD name and logo are registered marks of ACORD