Loading...
HomeMy WebLinkAbout521758 SUMMIT SEALANTS INC - INSURANCE CERTIFICATECERTIFICATE OF LIABILITY INSURANCE 5%2i/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: 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 endomement(s). . -":._- PRODUCER .. Colorado'SW Insurance Agency, InC7"-�ry 1211 North'-7th• Street -- - CONTACT Leandra Ludlam NAME: - -- -- _ PHONE.Ed, (970)243-9012 FAX o. (970)211-8175_ Eo ale ;leandre..ludlam@bankofthewest. cost INSURERS AFFORDING COVERAGE- NAICe PO'•BOx unct Grand Junct ion CO 81502 - - INSURERABerkle Recil Specialty Ins Cc - 31295 INSURED INSURER B.De ositors Insurance Compaurty 42587 INSURERC:St Paul Fire 6 Marine 24767 Summit Sealants, Inc. 1 INSUR D:Pinnacol Assurance 41190 13671 Carefree Drive INSURER E:American Risk Management ' Montrose, CO 81403 INSURER F : COVERAGES CERTIFICATE NUMBER:2014/2015 MASTER 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 OFADDLSUBR POLICY NUMBER POLICY EFF MM/DD/YYYY) POLICY EXP (MMIODffYYYI LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED PREMISES Me auvnence $ 100,000 A CLAIMS -MADE OCCUR X. GL0036925-25 6/l/2014 6/l/2015 -MED EXP(" one person). S _ 5,000 PERSONALS ADV INJURY- $ - 1,000,000 X—Primary Includes On -Going and _ X Non -Contributory, GENERAL AGGREGATE $ 2,000,000 ompleted Operations _ GEN'L'AGGREGATE.LIMIT APPLIES PER:' PRODUCTS - COMP/OP AGG.-$- 2,000,000 - '' ollution .. .6/l/2014 6/1/2015 X POLICY X PRO X LOC Pollution $ 2,000, 000 AUTOMOBILE LIABILITY, - COMBINED SINGLE LIMIT Ea accident 11000,000 BODILY INJURY (Per person) $ B ANY AUTO II X BODILY INJURY $ ALL OWNED SCHEDULED X X P7525193302 6/1/2014 6/l/2015 AUTOS AUTOS (Per accident) X HIRED AUTOS X NON &MED AUTOS PROPERTY DAMAGE P racodent $ Business AutoAdv.nteq. $ X UMBRELLA UAB X OCCUR EACH OCCURRENCE $ 4,000,000 AGGREGATE $ 4,000,000 C. EXCESS UAB CLAIMS -MADE UP13TO4762-14-NF DED X RETENTION$ 10,00 $ ollowing Form 6/l/2014 6/1/2015 * WORKERS COMPENSATION XI WC STATdU OTH- IT RANY AND EMPLOYERS' LIABILITY Y I NLIM E.L. EACH ACCIDENT $ 1,000,000 PROPRIETOR/ EXCLUDED' DFFIDER/MEMBER EXCLUDED? � NIA E.L. DISEASE - EA EMPLOYEE $ 1,000,000 (Mandatory In NH) 4076875 6/1/2014 6/1/2015 If yes, describe under E.L. DISEASE - POLICY LIMIT 1 $ 11000,000 DESCRIPTION OF OPERATIONS bel. B Inland Marine, Special hCP7525193302 6/1/2014 6/1/2015 Installation Float $20,000 From $1,000 Deductible Rented(Leased Equip $150,000 DESCRIPTION OF OPERATIONS / LOCATIONS/ VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) Project: Civic Center Parking Garage City of Fort Collins is named as Additional Insured as required per written contract SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Fort Collins ACCORDANCE WITH THE POLICY PROVISIONS. 300 W Laport Building. B AUTHORIZED REPRESENTATIVE Fort Collins, CO 80521 Carrie KOnakis/GRJCK ,-:51' -er 25 (20110106) ©1988-2010 ACORD CORPORATION. All riahts reserved. INS026 nrttmst ni Th. ecnlan namn anH Irmo.re rnniefnwd.nnrii of anrlOn