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Home My WebLink AboutMPB CONTRACTORS - INSURANCE CERTIFICATE (4)ACOR" CERTIFICATE OF LIABILITY INSURANCE III DATE 015 YYY) 1/26/2015 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 CONTACT NAME: Olson & Olson Ltd 5655 S. Yosemite St. #101 Greenwood Village CO 80111 PHONE FAX -- A.C. No: -- 2074 EJ.IAIL ADDRESS: INSURERS AFFORDING COVERAGE NAIL# INSURER A INSURED MPBCO-1 INSURER B:PinnaCOI Assurance INSURER C M PB Contractors 3155 Chambers Road Aurora CO 80011 INSURER D: INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: 979462016 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 INSURANCEADDLSUBR INSR WVD POLICY NUMBER POLICY EFF MMIDDIYYYY POLICY EXP MMIODIYYYY LIMITS A GENERAL LIABILITY TRA5122432 12015 12016 EACH OCCURRENCE $1000000 XDAMAGE COMMERCIAL GENERAL LIABILITY TO RENTED PREMISES Eocurrencel $500,000 CLAIMS -MADE 171 OCCUR MED EXP (Any one person) $5 000 PERSONAL B ADV INJURY $1,000,000 GENERAL AGGREGATE $2000000 GEN'L AGGREGATE UMITAPPLIES PER PRODUCTS - COMP/OP AGO S2000000 POLICY X PRO- XJECT LOC I I I $ A AUTOMOBILE LIABILITY TRA5122432 12015 12 MINED SI NGL LIMIT016 Ea accident .000.000 X BODILY INJURY (Per person) $ ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) S X PROPERTY DAMAGE Peracc0ent $ NON-OPMED HIRED AUTOS X AUTOS A X UMBRELLA LIAB OCCUR TRA5122432 12015 12016 EACH OCCURRENCE $5,000,000 AGGREGATE $5,000,000 EXCESSUAB CALMS -MADE DED X RETENTION$NIL $ B WORKERS COMPENSATION ANDEMPLOYERS'DABILITY YIN ANY PROPRIETOWPARTNERIEXECUTIVE OFFICERIMEMBER EXCLUDED? NIA 4058803 7112014 112015 X %STATU- OTH- YLIM E L. EACH ACCIDENT $500,000 E.L. DISEASE-EAEMPLOYEE S500.000 (Mandatory in NH) It yes, descnbe under DE SCRIPTIONOFOPERATIONSbeKW E.L. DISEASE -POLICY LIMIT S500.000 A Installation Floater TRA5122432 2J112015 12016 Building $1,000,000 Deduct S1,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remark. Schedule. if more apace i. required) Certificate Holder and those listed below(if any) are Additional Insureds as respects General Liability and Umbrella Liability on a Primary and Non -Contributory basis, and Auto Liability only if required by written contract or agreement and coverage applies only as respects work performed by the Insured for the Additional Insureds. All coverage terms, conditions, and exclusions of the policy apply. The Worker's Compensation, General Liability, Auto Liability, and Umbrella Liability policies include a Waiver of Subrogation in favor of the Additional Insureds only if required by written contract or agreement. Contractor's License. City of Fort Collins P.,O. 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 © 1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD