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HomeMy WebLinkAbout493216 CLASSIC CONTRACTORS INC - INSURANCE CERTIFICATE (6)Client#: 21095 CLASSICC4 ACORD,. CERTIFICATE OF LIABILITY INSURANCE OTE 1 3/13/2lOD(VVVV) 113/2015 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 endorsement(s). PRODUCER Bouchard insurance 101 N Starcrest Dr. CONTACT NAME: PHONE 72744T-6481 PAX727449-1267 AK: No Et): A/C No A RESS: cicertsftmyers@bouchardinsurance.com Clearwater, FL 33765 727 447-6481 INSURER(S) AFFORDING COVERAGE NAIL i INSURER A: Association Insurance Company 11240 INSURED INSURER B: Progressive Casualty 10194 Classic Contractors Inc Karl Schmidt INSURER C PO Box 2798 INSURER D : Loveland, CO 80539 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. INSR LTR TYPE OF INSURANCE ADDL N UBR POLICY NUMBER POLICY EFF MM/DD POLICY EXP LIMITS MWDDNYYV A GENERAL LIABILITY 014501502 3/11/2015 OECCCURRENCE 03/11/2016 EAAISES CCH� $1 000 000 $10O 000 X COMMERCIAL GENERAL LIABILITY EREM E¢ D r PERa oea CLAIMS -MADE F7x OCCUR MED EXP (Any one person) $5 000 $1 000,000 X PD PERSONAL& ADV INJURY $2,000,000 GENERAL AGGREGATE GEN'L AGGREGATE LIMIT APPLIES PER: $2,000,000 PRODUCTS-COMP/OP AGG POLICY PRO -a El LOc $ B AUTOMOBILE LIABILITY 021101062 3/12/2015 03/12M01 e aacci eDISINGLE LIMIT 110001000 BODILY INJURY (Per person) $ ANY AUTO ALL OWNED X SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ NON -OWNED HIRED AUTOS AUTOS A XUMBRELLAUAB X OCCUR 014501602 3/111201503/11/201 EACH OCCURRENCE $1000000 AGGREGATE $1 000 000 EXCESS LIAR CLAIMS -MADE DIED I X RETENTION$10000 $ WORKERS COMPENSATION WC STATU- OTH- TORY I IM AND EMPLOYERS' LIABILITY YIN ANY PROPRIETORIPARTNER/EXECUTIVE❑ OFFICER/MEMBER EXCLUDED? NIA E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ (Mandatory in NH) H yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT I $ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) NOTICE: Bouchard Insurance is required to comply with the licensing agreement we hold with ACORD. ACORD, in conjunction with the Department of Insurance, creates and enforces the rules and regulations pertaining to proper use of the Certificate of Liability Insurance form. (See Attached Descriptions) CITY OF FORT COLLINS PO BOX 580 FORT COLLINS, CO 80522 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) 1 of 2 #S142463/M142459 The ACORD name and logo are registered marks of ACORD REBRO DESCRIPTIONS (Continued from Page 1) We are required to mark a Y next to the line of business in which the Additional Insured or Waiver of Subrogation coverage applies. According to ACORD, the Description of Operations section must be limited to describing information necessary to identify the operations, locations and vehicles for which the certificate was issued. Please note the Description of Operations section of the Certificate cannot be used to add additional information except as just described. Marking a Y next to the line of business adequately documents coverage. Equally important, it satisfies the rules and regulations governing the proper use of the Certificate of Liability Insurance form. Certificate is a reflection of the current coverages provided for the insured. Limits and coverages are afforded to the certificate holder only if required by written contract. THE CERTIFICATE HOLDER IS AN ADDITIONAL INSUREDS AS RESPECTS GENERAL LIABILITY, ONLY IF REQUIRED BY WRITTEN CONTRACT AND SUBJECT TO THE TERMS, CONDITIONS, AND LIMITS AS SPECIFIED IN THE POLICY. RE: 7544 OLD TOWN PARKING GARAGE CANOPY SAGITTA 25.3 (2010/05) 2 of 2 #S142463/M142459