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Home My WebLink About157609 WESTMARK HOMES LLC - INSURANCE CERTIFICATE (3)OP ID: CT ,a►coRo CERTIFICATE OF LIABILITY INSURANCE DATE/02/201 0302/205 �i 15 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 Phone: 970-223-1804 CONTACTNAME: VolkBell Property & Casualty PHONE FAX 1100 Haxton Dr. Suite #100 Fax: A/C,No, ExO: _(A/C, No): Fort Collins, CO 80525 E-MAIL Steven G. Smith ADDRESS: PRODUCER C.IIRTOMFR In! WESTM-1 INSURED Westmark Homes LLC INSURERA: Builders Insurance Group Rick Myers INSURER 6: Pinnacol Assurance 41190 PO Box 272759 Fort Collins, CO 80527 INSURER C: INSURER D : 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. INo No TYPE TYPE OF INSURANCEMM- POLICY NUMBER MMIDDYEFF M POLICY YYY A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE I OCCUR GLP 0099055 04 03/01/2015 03/01/2016 EACH OCCURRENCE $ 1,000,00 PREMISES Ea occurrence $ 100,00 MED EXP (Any one person) $ 5,00 PERSONAL BADV INJURY $ 1,000,00 GENERAL AGGREGATE E 2,000,0011 GEEN'L AGGREGATE LIMIT APPLIES PER X POLICY PRO- LOC PRODUCTS - COMP/OP AGG E 2,000,00 $ AUTOMOBILE LU\BILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS COMBINED SINGLE LIMIT (Ea accident) 9 BODILY INJURY (Per person) f BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ $ E UMBRELLA LIAB EXCESS LIAR OCCUR CLNMS4AADE EACH OCCURRENCE $ AGGREGATE $ DEDUCTIBLE RETENTION $ $ $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY N Yin ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? � (Mandatory In NH) If yes, desmbe under DESCRIPTION OF OPERATIONS below N/A 103840 05/01/2014 05/01ilOiS X WC STATU- OTH- IT E.L. EACH ACCIDENT 5 100,00 E.L. DISEASE - EA EMPLOYE S 100,00 E.L. DISEASE - POLICY LIMIT I $ 500,00 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space is required) City of Fort Collins is named as additional insured. CERTIFICATE HOLDER CANCELLATION CITYFCI SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Fort Collins ACCORDANCE WITH THE POLICY PROVISIONS. PO Box 580 AUTHORIZED REPRESENTATIVE Fort Collins, CO 80522 ©1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009/09) The ACORD name and logo are registered marks of ACORD