HomeMy WebLinkAbout109363 ALLIANCE CONSTRUCTION SOLUTIONS LLC - INSURANCE CERTIFICATE (2)h. O CERTIFICATE OF LIABILITY INSURANCE
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ATE
12/30/2014
D2/30/2014)
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: H 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 -
Moody Insurance Agency, Inc. _
8055 East Tufts Avenue
$tllte lOOO -
Denver CO 80237
CONTACT Eileen Munoz
NAME:
PNONE _ (303) 824-6600 FAAiCX No: (303)370-0118
E-MAIL .emunoz@moodyins.com
INSURERS AFFORDING COVERAGE
NAICN
INSURERA:Travelers Indernnity Company
5658
INSURED
Alliance Construction Solutions LLC
2260 N. Broadway
Denver CO 80205'
INSURER B:Travelers Prop Cas Co of Amrca
25674
INSURERC:AnLer Guarantee Liab Ins Co
26247
INSURER o:Pinnacol Assurance
41190
NSURER E I
INSURER F:
COVERAGES CERTIFICATE NUMBER:15/16 No Fomrs 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.
INTR
TYPE OF INSURANCE
ADDL
R
POLICY NUMBER
POLICY EFF
MM/DONYYY
POLICY EXP
MMMONYYYI
LIMITS
GENERAL LIABILITY
EACH OCCURRENCE
$ 11000,000
A
X COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE OCCUR
DTC0016IL68AIM15
/1/2015
/1/2016
DAMAGE TO RENTED
PREMISES Ea oocurrence
$ 300, 000
MED EXP (My one personi
S 51000
PERSONAL$ ADV INJURY
$ 11000,000
GENERAL AGGREGATE
S 2,000,000
GEHL AGGREGATE
LIMIT APPLIES PER.
PRODUCTS - COMP/OP AGG
$ 2,000,.000
X POLICY
X PRO LOG
E .
AUTOMOBILE
LIABILITY
COMBIaEED SINGLE LIMIT
EBI
1,000,000
X
BODILY INJURY (Per person)
$
B
ANY AUTO
ALL OWNED SCHEDULED
AUTOS AUTOS
DT81001151L68ATIL15
1/1/2015
1/1/2016
BODILY INJURY (Per accidem )
$
NON -OWNED
HIRED AUTOS AUTOS
-
PROPERTY DAMAGE
Per accidmf
$
S
X
UMBRELLA LIAB
X
OCCUR
EACH OCCURRENCE
$ 10,000,000
AGGREGATE
$ 10,000,000
L.
EXCESS LIAB
CLAIMS -MADE
DED X RETENTION
$
UC914113808
/1/2015
1/l/2016
D
WORKERS COMPENSATION
AND EMPLOYERS'LIABILITY Y/N
ANY PROPRIETOWPARTNEREXECUTIVE
OFFICEWMEMBER EXCLUDED?
(Mandatory in NH)
If yes, describe under
DESCRIPTION OF OPERATIONS below
N/A
4038468
/1/2015
/1/2016
Y WC STATU- OTH-
TS
EL EACH ACCIDENT
$ 11000,000
E. L. DISEASE - EA EMPLOYEE
$ 1,000,000
E.L. DISEASE -POLICY LIMIT
$ 11000,00
B
Builder's Risk[
QT6605892N166TIL15
1/1/2015
1/1/2016
NC MNC MFR FR Limit 10,000,000
Special F
Deductible $5,000
Frame JM Umll 3,000,000
DESCRIPTION OF OPERATIONS / LOCATIONS/VEHICLES (Attach ACORD 101, Additional Remarks Schedule, 9 more space is required)
RE: Contractor's License A-96
City of Fort Collins
PO Box 580
Fort Collins, CO 80522-0580
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
25
ileen Munoz/CHRMIL /
01988-2010 ACORD CORPORATION. All rinhte reserved.
INS025 (201005),01 The ACORD name and logo are registered marks of ACORD