HomeMy WebLinkAboutD & D ROOFING INC - INSURANCE CERTIFICATE (3)YRu@Wm
3
a A` CERTIFICATE OF LIABILITY INSURANCE 10/03/2014YY)
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 terns 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 endorsement(s).
PRODUCER 1-303-534-4567 CONTACT
IIAME:
IM, Inc. - Colorado Division PHONE FAX
INC, No, Eat) _ INC, Nog
1]OS 17th Street
EDDRE denpamLAimacorp.com
ADDRESS:
Suite 100
INSURER(S) AFFORDING COVERAGE
fI
HAIG8
Denver, CO 80202 _
INSURER A_ WESTFIELD INS CO
24112
INSURED
INSURER B: NATIONAL UNION FIRS INS CO OF PITTS(All
19445
BAD Roofing Inc.
- - -
INSURER C
6270 B. 50th Ave.
INSURERD: -
INSURERE: _
Commerce City, CO 80022 1
INSURER F:
I
COVERAGES CERTIFICATE NI NI 41759331 09VICIAM U"UoCD.
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCES 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.
POLICY EFF
Lm TYPE OF INSURANCE IADOLIwva POLICY NUMBER I MMIDONYYYY I POUCYYYY I LIMITS
A
X
COMMERCIAL GENERAL LIABILITY
CH1,11827928
10/01/14
10/01/15
EACH OCCURRENCE
1$ 1,000,000
CLAIMS MADE I X I OCCUR
GE TO
I
PR SES (EaBcccur Noce)
$ 500,000
X
PD Ded: $10,000 _
ME_D EXP(My man pamon)
$ 5,000
PERSONAL S ADV INJURY_
S 1,000,000
GENT
AGGREGATE LIMIT APPLIES PER'.
GENERAL AGGREGATE
E 2.000,000
-�
POCYPRODUCTS
%_ JECOT I LOC
AGG
$ 2, 000, 000
OTBER.I
$
A
AUTOMOBILE
LIABILITY
CXM1827928
10/01/14
10/01/15
COMBINED SINGLE LIMIT
$ 1-1000—,0
(Ea accicau)-
00
X
ANY AUTO
BODILY INJURY IPer person)
S
AUTOS SCHEDULED
AUTOS AUTOS
(er accident
BODILY MJURY P )I
E
X
HIREDAUTOS Y NONS ED
AUTOS
PRNERTY DAMAGE
1Par. dri D_
IS
$
B
UMBRELLA LAB Y OCCUR
I (CLAIMS
BE044059728
10/01/14
10/01/15
EACH OCCURRENCE
$ 1,000,000
X
EXCESS LAB -MADE
AGGREGATE
$ 1,000,000
I
DED (RETENTIONS
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY YIN
(STEIR ATUTE IOERH
'-
ANY PROPRIETOR/PARTNERIEXECUTIVE
E L. EACH ACCIDENT S
OFFICENMEMBER EXCLUDED' ❑
NIA
- -- - I
(Myyaaantlamry In NN)
E.L. DISEASE - EA EMPLOYEE S
OESCRIPSTION OurOPERATIONS Where
E.L. DISEASE POLICY LIMIT($
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may 6e amched H mom space Is required)
City of Fort Collins is included as Additional Insured on the General Liability Policy if required by written contract
or agreement and with respect to work performed by Insured subject to the policy terms and conditions.
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
of Fort Collins THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
North Moon Street,
AUTHORIZED REPRESENTATIVE
Colli/Wns, CO 80522 / I USA /,
All riahts reserved.
ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD
ke13ym2013
41759331