HomeMy WebLinkAboutALLIANCE ROOFING INC - INSURANCE CERTIFICATEP5V�W..12
C • DATE 4YYI
A `/ CERTIFICATE OF LIABILITY INSURANCE la/22/201a/aDla
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 1-303-233-2828 CONTACT Scott OTCLCC
NAME: _ _
Orcutt Insurance Group, LLC PHONE FAX
UUC.NP.E.H: 303.233-2828 I (Nc Rol; 303-233-6570
965 S. RiDlin9 Pkwy, Ste B ADDRESS: Sorcutt@orcuttgroup.com
ADDRE._ _ 9rou D•
Lakewood, CO 00226 _ INSURER(S) AFFORDING COVERAGE NAIC_-
A943338 INSURER A: PINHACOL ASSURANCE 61190
INSURED INSURERS:
Alliance Rooting, Inc. _ -- _.. --- - -- - - - -- - ---- -- ----
INSURERL:
C/o Resource Management Systems, Inc. INSURER D:
6665 3 Greenwood Plaza Blvd., Suite 650 INSURER E:
Centennial, CO 80111
rnlreonree PCOTICIPATC NIIMRFD- 19A?49Q0 RFVlglnN NIIMRFR-
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.
DULIWVDI SUBR POLICYSIFF
C;m TYPE OF INSURANCE POLICY NUMBER MMMDINYYI (MMIDDPOUCYEXP_ftYYYI LIMITS
GENERAL LIABILITY
EACH OCCURRENCE
$_______
_
_
DAMAGE TO RENTED
GENERAL_ LIABILITY
PREMISES(Ee occunence) _.
S
It
_COMMERCIAL
_ CLAIMS -MADE OCCUR
MED EXP(Any one parson)
PERSONAL a_ ADV INJURY
..
$
GENERAL AGGREGATE
3___—_____-_�_-_
GEN'L AGGREGATE LIMIT APPLIES PER:
PRODUCTS - COMPIOP AGG
_.._—
S --.-_-_
POLICY IPHI _ _ LOC
JECT
$
AUTOMOBILE LIABILITY
COMBINED SINGLE LIMIT
(Ea a«eenl)
ANY AUTO
BODILY INJURY(Per pemnn)
$
ALL OWNED (SCHEDULED
BODILY INJURY(Psr awgeM)
$
AUTOS T S--
PROPE
— ---
If
HIREDAUTOS _ IAUT SV/NED
(P.ac IDA- --
-_
-
UMBRELLA UJUS Ld OCCUR
EACHOCCURRENCE ...
S
EXCESS LWB CVUMSMADE
AGGREGATE
DEO I I RETENTION $
$
A
WORKERS COMPENSAIIOM
4098638
Ol/Ol/15
01/01/16
XI WC STATU OTH-
ANDEYPLOYERS'LIAeILRY Y I N
TORY LIMITS ER_
AN PROPRIETORNARTNENEXECUTIVE
E L EACH ACCIDENT
S 1, 000, 000
OFFICERAIEMBER EXCLUDED?
NIA
-- -
-'---- ----
(WedYoryinNH)
E.L. DISEASE - EA EMPLOYE_
-
$ 1, 000, 000
II9e*aesciheenoer
DESCRIPTION OF OPERATIONS ImIaM
EL DISEASE -POLICY LIMIT
3 1, 000, 000
I
DESCRIPTION OF OPERATORS I LOCATIONS I VEHICLES (AtMch ACORD 101, AddKional RMpmlu* Schedule, If mom spat* Is r*9ulnd)
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.
281 North College Ave AUTHORIZED REPRESENTATIVE
PO BOY SBO
Fort ColliON, CO 80522
USA
All nnhfA mvervnd.
ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD
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