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HomeMy WebLinkAboutFRAMEWORKS TIMBER - INSURANCE CERTIFICATE (2)FRAME-1 OP ID: CA , 6* o_ CERTIFICATE OF LIABILITY INSURANCE �� YY) DATE F03/0912015 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 Woo8231ington Cent alAAvecy, LLC Cheyenne, WY 82001 Will de Ryk NAMEACT Will de R k AICONNo ,R,307-772-3333 AIIC Ne: 307-634-3914 ADDRIESS: wili@wyoagency.com INSURERS AFFORDING COVERAGE NAIC # INSURER A: VInin s Insurance Company INSURED Frameworks Timber INSURERS: Pinnacol Assurance 208 Racquette Dr., Unit B Fort Collins, CO 80524 INSURERC: 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. IPOLICY LTR TYPE OF INSURANCE JUMOL SUBA POLICY NUMBER Y EFF MWDD EXP MWDDIYYYY LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE XOCCUR I PKG0151437 I 06/14/2014 06/14I2015 EACH OCCURRENCE $ 1,000,00 DAMAGE To R PREMISES Ea occurrence $ 100,00 MED EXP (Any one person) $ 5,00 PERSONAL & ADV INJURY $ 1,000,00 GEN'L AGGREGATE LIMIT APPLIES PER: X POLICY ❑ JET LOC OTHER GENERAL AGGREGATE $ 2,000,00 PRODUCTS - COMP/OP AGG $ 2,000,00 $ AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS NON -OWNED HIREDAUTOS AUTOS COMBINED SINGLE LIMIT Ea accident $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ $ UMBRELLA LIAB EXCESS LIAR OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DED I I RETENTION$ $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N OFFICER/MEMBER EXCLUDED? ❑ (Mandatory in NH) If yos, d describe uner DESCRIPTION OF OPERATIONS below N / A 4121487 03/01/2015 03/01/2016 PER OTH- STATUTE I ER E.L. EACH ACCIDENT $ 500,00 E.L. DISEASE - EA EMPLOYE $ 500,00 E.L. DISEASE - POLICY LIMIT $ 500,00 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) REF: City of Ft. Collins is an Additional Insured under the Blanket Additional Insured Endorsement. City of Ft. Collins Attn: John Stevens 281 N. College Ft. Collins. CO 80524 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 (AJ �- C IL ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD