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Home My WebLink About101127 4-K PAINTING & DRYWALL INC - INSURANCE CERTIFICATEA`� & CERTIFICATE OF LIABILITY INSURANCE 7/11/2014 Y) 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 Colorado BW Insurance Agency, Inc. 1075 W Horsetooth Rd, Ste 106 Fort Collins CO 80526 CNAMONTACTE: Dennis Shafer PHONE F.H. (970)223-0924 1 FA% Nc, (970)267-2231 E�mA,'L,,,.dennio.shafer@bankofthewest.com INSURERS AFFORDING COVERAGE NAIC0 INSURERA:United Fire & Casualty Group INSURED 4K Painting & Drywall, Inc. 3121 Kintzley Court Unit #G Laporte CO 80535 INSURER B INsuRERc: INSURER D: INSURER E : INSURER F: r IcRAcEg CERTICIr!ATF 1UHNIRFO-CL1471174557 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. WSR TYPE OF INSURANCE OL Am MCI POLICY NUMBER POLICY MMDD M LOY E%P LIMITS GENERALLIABILITY EACH OCCURRENCE $ 11000,000 X COMMERCIAL GENERAL LIABILITY X PREMISES 4E& o=rmrcal $ 100,000 MED EXP Anyone son) $ 51000 A I CLAIMS-0ADE F0OCCUR D104 01489135 /23/2014 1/1/2015 PERSONAL& ADV INJURY 3 1,000,000 GENERAL AGGREGATE S 2,000,000 GENT AGGREGATE LIMIT APPLIES PER PRODUCTS - COMP/OP AGG $ 2,000,000 S -XJ POLICY X PRO LOC AUTOMOBILE LIABILITY EOMBIceDI INGL LIMIT 11000,000 BODILY INJURY (Pw Person) $ A ANY AUTO ALL OWNED X SCHEDULED AUTOS AUTOS NON -OWNED X HIRED AUTOS X AUTOS X D104 01489135 /23/2014 1/1/2015 BODILY INJURY (Per ecGdenl) E PROPERTY DAMAGE Pm $ Undc,muma motwnt 81 - la $ 1 000 000 X UMBRELLA UAB OCCUR EACH OCCURRENCE $ 2, 000, 000 AGGREGATE $ A EXCESS UAB CLAIMS -MADE 0104 01489135 /23/2014 /1/2015 DED I I RETENTION$ 10, OOC S WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS' LABILITY ANY PROPRIETORMARTNER/EXECUTIVE a E.L. EACH ACCIDENT $ E.L. DISEASE -EA EMPLOYE $ OFFICERAIEMBER EXCLUDED? (Mandatory In NH) NIA E.L. DISEASE -POLICY LIMIT E IIy desnibe under DESCRIPTION OF OPERATIONS belm DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ABac11 ACORD 101, AdcMiorut Remarks Schedule, N mom apace Is required) The certificate holder is named as an Additional Insured with respects to the ongoing operations of the Named Insured on the General Laibility coverage. CERTIFICATE HOLDER CANCELLATION (970) 224 - 6134 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 Building & Permits P.Q. BOX S8O AUTHORIZED REPRESENTATIVE Fort Collins, CO 80522-0580 / Y fA-W4 ACORD 25 (2010/06) ©A1988.2010 ACORD C IP TION. All rights reserved.