HomeMy WebLinkAboutPINECREST DEVELOPMENT CO LLC DBA PINECREST CUSTOM - INSURANCE CERTIFICATEOP ID: CT
,a►coRo CERTIFICATE OF LIABILITY INSURANCE
DATE (v1012o14
11on
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 Phone: 970-223-1804
VolkBell Prope�t�, & Casualty
1100 Haddon Dr. §uite 9100 Fax:
Fort Collins, CO 80525
Steven G. Smith
CONTACT
PHONE FAX
ac Ne. .970-223-1804 uc Ne : 970-225-6596
EMAIL
ADDRESS:
PRODUCER
CUSTOpINEC-2
MER ID p:
INSURER(S) AFFORDING COVERAGE
NAIL#
INSURED Pinecrest Development Co.,LLC
INSURER A: First Mercury Insurance
dba Pinecrest Custom Homes LLC
Tom Dugan
4225 Westshore Way
INSURER 8: Zurich North America
INSURER C: Lloyds of London
.INSURER O:
Ft. Collins, CO 80525
INSURER E :
INSURER F :
COVERAGES CERTIFICATE NUMBER: 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
DLrUBR
INSR
WvC
POLICY NUMBER
POLICY EFF
MMMO
POLICY UP
M"D
LIMITS
GENERAL LIABILITY
EACH OCCURRENCE
$ 1,000,00
PREMISES Ea na-ce
$ 100,00
A
X COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE OCCUR
MACGL000001946302
11/0112014
11/01/2015
MED UP (My one person)
S 5,00
PERSONAL S ADV INJURY
$ 1,000,00
X
Professional
GENERAL AGGREGATE
$ 2,000,00
C
ANE125591713
02/0912014
02/09/2015
GEN'L AGGREGATE LIMIT APPLIES PER:
PRODUCTS - COMP/OP AGO
S 2,000,00
X POLICY PRa LOC
Prof
$ 500,000
AUTOMOBILE
LIABILITY
COMBINED SINGLE LIMIT
(Ea acudent)
$
ANY AUTO
BODILY INJURY (Per person)
$
ALL OWNED AUTOS
BODILY INJURY (Per accident)
$
SCHEDULED AUTOS
HIRED AUTOS
PROPERTY DAMAGE
(Per accident)
$
$
NON -OWNED AMOS
UMBRELLA LIAR
OCCUR
EACH OCCURRENCE
S
gGGREGATE
$
EXCESS LIAR
CLAIMS -MADE
DEDUCTIBLE
$
RETENTION $
WORKERS COMPENSATION
WC STATU- OTH-
AND EMPLOYERS' LIABILITY Y/ N
ANY PROPRIETORIPARTNER/EXECUTIVE
OFFICEWMEMBER EXCLUDED7 ❑
N/A
T RY LIMIT$ ER
E.L. EACH ACCIDENT
$
E.L. DISEASE - EA EMPLOYE
$
(Mandatory In NH)
U yes, desalbe under
DESCRIPTION OF OPERATIONSbelow
E.L. DISEASE -POLICY LIMIT I
$
B
Builders Risk
BR69078329
12/02/2013
12/02/2014
Mntly Rpt 1,500,000
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES IAfach ACORD 101, AddMoml Remarks Schedule, if more apace la required)
970-224-6134
City of Fort Collins
Building Department
PO Box 580
Fort Collins, CO 80522
CITY OF
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
01988.2009 ACORD
reserved
ACORD 25 (2009/09)
The ACORD name and logo are registered marks of ACORD