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HomeMy WebLinkAbout475768 TRINITY STRUCTURAL COMPONENTS LLC - INSURANCE CERTIFICATE (3)ACORbr CERTIFICATE OF LIABILITY INSURANCE DATE (MM DDnryY) 6/26/2014 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 endorsemen s . PRODUCER CONTACT NAME: MHBT Inc. 8144 Walnut Hill Lane, 16th Floor Dallas TX 75231 PHONE FAX AIC No: E-MAIL ADDRESS: INSURERS AFFORDING COVERAGE NAIC p INSURER AACE American Insurance Company ?9667 INSURED TRIN I IND1 INSURERS INSURER C: Trinity Structural Components, LLC P O Box 568887 Dallas, TX 75356-8887 INSURER D: INSURER E INSURER F : COVERAGES CERTIFICATE NUMBER: 1214685567 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 INSURANCE INSR MID POLICY NUMBER POLICY EFF MMMDNYYY POLICY E%P MMIDD/YYYY LIMITS A GENERAL LIABILITY HDOG27021165 /1/2013 /1/2014 EACH OCCURRENCE $5,000,000 x COMMERCIAL GENERAL LIABILITY Fvi CLAIMS -MADE I I OCCUR DANIA ET RENTED PREMISES Ea occurrence $50,000 MED EXP(Any one parson) $10,000 PERSONAL B ADV INJURY $5,000,000 GENERALAGGREGATE $7,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMPIOP AGG $7,000,000 x I POLICY PRO- LOC I $ A A AUTOMOBILE LIABILITY ANY AUTO ISAH08826936 ISAH08826948 /1/2014 /1/2014 /1/2015 /1/2015 Ea accident .000000 x BODILY INJURY (Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ x PROPERT Per aWden DAMAGE $ NONO HIREDAUTOS X AUTOSWNED UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DED I I RETENTION$ $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOMPARTNERIEXECUTIVE OFFICERIMEMBER EXCLUDED? O NIA WLRC48013454 71112014 /112015 X WCSTATU- DTH- All State$ E.EACH ACCIDENT L. $2,000.000 E.L. DISEASE - EA EMPLOYEE $2,000,000 (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $2,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remark. Schedule, If more space I. required) Certificate Holder includes: City of Fort Collins, its Officers, agents and employees The General Liability policy includes a blanket additional insured endorsement to the certificate holder only when there is a written contract between the named insured and the certificate holder that requires such status. The Automobile Liability policy contains language that provides additional insured status to the certificate holder only when there is a written contract between the named insured and the certificate holder that requires such status. City of Fort Collins Attn: Purchasing 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 ACORD 25 (2010105) ©1988-2010 ACORD The ACORD name and logo are registered marks of ACORD