HomeMy WebLinkAbout101137 PINKARD CONSTRUCTION - INSURANCE CERTIFICATE (4)PStux,]wpL r ACC>RO® DATE0I �./J CERTIFICATE OF LIABILITY INSURANCE to/27/2z7/ao1414 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 endorsement(s). PRODUCER 1-303-534-4567 CONTACT NAME: - ... INA, Inc. - Colorado Division PHONE IFAX INC, No, Edo: ! (AC, No): _ E-MAIL denyaakiistacorp.Con 1705 17ih Street ADDRESS: _ Suite 100 INSURERIS) AFFORDING COVERAGE NAICN Denver, CO 80202 _ _ INSURER A: ZURICH AdKER INS CO 116535 INSURED INSURER 6: ANERICAN GUAR & LIAR INS (Zurich N. 126247 Pinkard Construction Co. PINNACOL ASSUR I41190 INSURER C: _ _ _ _ _ 9195 West 6th Avenue INSURER D: - INSURERE_ _ Lakewood, CO 80215 INSURER F: COVERAGES CERTIFICATE NUMBER: 41939583 REVISION NUMBER: THIS IS TO CF_RTIFY 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 CONTRACTOR 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. IRISH I TYPE Of INSURANCE 'ADDL BUBB POLICY EFF j POLICY EXP 1 UNITS LTR POLICY NUMBER MMIDDIYYYY MMIODIYYYY 1 A X COMMERCMLGENERALLULBILRY GW931935603 11/01/14 11/01/15 EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE I X I OCCUR DAMAGE TO RENTED PREMISES (Ea occurrence) $ 300,000 X I $5,000 Deductible MED EXP(Any one person) S 5,000 PERSONAL B ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY X l JECT (LOG PRODUCTS-COMPIOP AGO $ 2,000,000 OTHER: $ A AUTOMOBILE LIABILITY BAP931935503 11/01/14 11/01/15 COMBINED SINGLE LIMIT I$ 1,000,000 X (ANY AUTO ( (Ea accidenq BODILY INJURY(Perpe,aml $ ALL OWNED (SCHEDULED BODILY INJURY (Per accident$ AUTOS (AUTOS X (NON -OWNED X PROPERTY DAMAGE - - HIRED AUTOS 1 I AUTOS (Per accident) _ s �X B X (UMBRELLA LIAB OCCUR AUCS83445202 11/01/14 11/01/15 EACH OCCURRENCE I$ 10,000,000 EXCESS LIAB CLAIMSAAA_D_E _ AGGREGATE $ 10, 000, 000 DED I X RETENTIONS 0 Is C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY I2321400 30/Ol/14 10/Ol/15 X PER OTH- (STATUTE DER YIN ANY PROPRIETORIPARTNERIEXECUTIVE H (NIA I E.L. EACH ACCIDENT $500,000 - OFHCERIMEMBER EXCLUDED? (MandatorylnNH) E.L. DISEASE $ 500,000 If yes. describe Under -EAEMPLOYEE I. DESCRIPTION OF OPERATIONS below I E.L. DISEASE -POLICY LIMIT 1 $ 500,000 i DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks SchMule, may be attached H more space is required) Certificate Holder 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. A Waiver of Holder on the General Liability and Workers Compensation Policies if required by written contract or agreement subject to the policy terms and conditions. conditions. RE: c License #A-71 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Fort Collins THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 281 N. College Ave "' AUTHORIZED REPRESENTATIVE P.O. Box 580 R Fort ColliI ns, CO 80522-0580 USA /! ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD emeando 41939583 CERTIFICATE OF LIABILITY INSURANCE DATE(M"OIYYYY) 10/27/2014 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 endorsement(s). PRODUCER 1-303-534-4567 CONTACT NAME: INA, Inc. - Colorado Division PHONE FAX INC. No, Est): I INC, No): _ 1705 17th Street E-MAIL denpal0@imacorp. corn E-MAILS: Suite 100 INSURER(S) AFFORDING COVERAGE NNCt Denver, CO 80202 _ INSURER A: ZURICH AMER INS CO 16535 INSURED INSURER B: AMERICAN GUAR 8 LIAB INS (Zurich N. 26247 Pinkard Construction Co. INSURER L: PINNACOL ASSUR 41190 _ 9195 West 6th Avenue INSURER O: INSURER E: _ Lakewood, CO 80215 INSURER F: COVFRAGFS CERTIFICATE NUMRFR- 41939420 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. ADOV $DeN INm IXP LTR TYPE OF INSURANCE I POLICY NUMBER MMIODIYYYY MMIODIYYYY I LIMITS A Y COMMERCIAL GENERAL LIABILITY GW931935603 11/01/14 11/01/15 EACH OCCURRENCE S 1,000,000 I X I DAMAGE TO RENTED 300,000 LLAIMS-M&DE OCCUR PREMISES (Ea mcerence) S X $5,000 Deductible MED EXP(Any we Waon) 1 5,000 PERSONAL B ADV INJURY S 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER. GENERAL AGGREGATE S 2,000,000 X IJEI I ILOC PRODUCTS - COMPIOP AGO $ 2,000,000 OPOLICY THER:I $ A AUTOMOBILE LIABILITY BAP931935503 11/01/14 11/01/15 COMBINED SINGLE LIMIT g 1,000,000 X ANY AUTO BODILY INJURY (Per person) $ ALL OWNED SCHEDULED I BODILY INJURY (Per accident) $ AUTOS (AUTOS X X pUTOGWNED (PeYacoBitlenq DAMAGE S HIRED AUTOS I I $ B Ix UMBRELLALIAB Y OCCUR AUC583445202 11/01/14 I EACH OCCURRENCE S 2,000,000 EXCESS UALS CLNMS-MADE I �11101115 AGGREGATE S 2,000,000 BED 1 X I RETENTION $ 0 ( $ C VIORNERS COMPENSATION 2121400 10/01/14 10/O1115 XISTATUTE TERN AND EMPLOYERS' LIABILITY YIN ANY PROPRIETORIPARTNERIEXECUTIVE E.L. EACH ACCIDENT $ 500,000 OFFICERIMEMBER EXCLUDED? ] NIA (Myandatory in NH) EJ EL OISSE - EA EMPLOYEE $ 500,000 If I 500,000 DESCRIPTION OF OPERATIONS Cebw. E.L. DISEASE -POLICY LIMIT S DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, AddlUonel Remarks Schedule, may be attached If mom spew Is required) of Foit Collins':. 1 N. College Ave O. Box 580 rt Collins, CO 80522-0580 ACORD 25 )2014101) emsando 41939420 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. USA _ / / ,& 01988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD a t` P tzil