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HomeMy WebLinkAbout330878 SIMPSON & SIMPSON SALES & SERVICE INC - INSURANCE CERTIFICATE (3)ACORO® CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDM Y) an2rzota 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 CONTACT NAME: PHONE FAX INC.No ) 3103-85Z-2074 Olson & Olson Ltd 5655 S. Yosemite St. #101 Greenwood Village CO 80111 E-MAIL ADDRESS: INSURERS AFFORDING COVERAGE NAICA INSURER :Wesffleld Insurance Company 24112 INSURED SIMPS-1 INSURERB: INSURER C:Allianz Global Risks US Ins Cc 35300 Simpson & Simpson Sales & Service, Inc. Russ Doty PO BOX 524 INSURER D: Broomfield CO 80038 INSURER E NSURER F: COVERAGES CERTIFICATE NUMBER: 1900033151 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 INSURANCEAUULbUWK INSR WV POLICY NUMBER POLICYEFF MMIOD POUCYEXP MIdIDDIWYV LIMITS A GENERAL LIABILITY WP5452191 /12014 /12015 EACH OCCURRENCE $2000000 X COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence s300,000 CLAIMS -MADE OCCUR MED EXP(Any one person) $10,000 PERSONAL &ADV INJURY $2,000,000 GENERAL AGGREGATE $4000000 GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS - COMPIOP AGO $4000000 $ POLICY X PRO- IPIT X LOC A AUTOMOBILE LIABILITY CWP5452191 /12014 /12015 COMBINED SINGLE LIMIT Ea accident 1000.000 BODILY INJURY (Per Person) $ ANY AUTO ALL OV EO SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ X PROPERTY DAMAGE Per accident $ NON-OwJED HIRED AUTOS X AUTOS $ A UMBRELLA LIAB X OCCUR CVVP5452191 /12014 /12015 EACH OCCURRENCE $2,000,000 AGGREGATE s2,000,000 EXCESS LIAB CLAIMS -MADE DED I X I RETENTION$0 S B WORKERS COMPENSATION 4095690 /12014 /l2015 WC STATU- OTH- ANDEMPLOYERS'LIA9ILITY YIN ANY PROPRIETOR/PARTNERrEXECUTIVE E.L. EACH ACCIDENT $1.000,000 OFFICEWMEMBER EXCLUDED? ❑ NIA EL DISEASE- FA EMPLOYEE S1.000,000 (Mandatory In NH) It yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT S1,000,000 C BR/Inst Floater MZ193022731 /l2014 /12015 Materials S500,DDO Deduct $1,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ANach ACORD 101, Addaiorwl Ramarkc Schedule, ilmore apace is regeiretl) Certificate Holder and those listed below(if any) are Additional Insureds as respects General Liability and Umbrella Liability on a Primary and Non -Contributory basis, and Auto Liability only if required by written contract or agreement and coverage applies only as respects work performed by the Insured for the Additional Insureds. All coverage terms, conditions, and exclusions of the policy apply. The Worker's Compensation, General Liability, Auto Liability, and Umbrella Liability policies include a Waiver of Subrogation in favor of the Additional Insureds only if required by written contract or agreement. All Projects. City of Fort Collins 300 LaPorte Ave Ft 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 AUK- © 1988-2010 ACORD ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD