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Home My WebLink About157609 WESTMARK HOMES LLC - INSURANCE CERTIFICATE (4)OP ID: CT A�AO CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/WVl) 03125I2015 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 CONTACT VOIkBell Property & Casualty PHONE FAX 1100 Haxton Dr. Suite #100 Fax: (AIc No EMI, -ILA/Cl No): Fort Collins, CO 80525 E-MAIL Steven G. Smith ADDRESS: PRODUPR.gT aCPR m a•WESTM-1 INSURED Westmark Homes LLC INSURERA:Builders Insurance Group Rick Myers PO Box 272759 INBURERe:Pinnacol Assurance 41190 Fort Collins, CO 80527 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. ow LTR TYPE OF INSURANCE POLICY NUMBER MMIDDY EFP POLICYEXP DMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LmaurV CLAIMS -MADE rK OCCUR GLP 0099055 04 03101/2015 03/01/2016 EACH OCCURRENCE $ 1,000,00 PREMISES Ea occurrence $ 100,00 MED EXP (Any one person) $ 5,00 PERSONAL S ADV INJURY $ 1,000,00 GENERAL AGGREGATE $ 2,000,0011 GEN'L AGGREGATE LIMIT APPLIES PER: I CTX POLICY PRO- LOC PRODUCTS-COMP/OP AGG $ 2,000,0011 $ AUTOMOBILE IJABILTTY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) $ BODILY INJURY (Par accident) $ PROPERTY DAMAGE (Per accident) $ $ $ UMBRELLA LIAR EXCESS LIAB OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DEDUCTIBLE RETENTION S $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN B ANY PROPRIETOR/PARTNER/EXECUTNE OFFICER/MEMBER EXCLUDED? ❑ (Mandatory In NH) tl yes, tlescnbe under DESCRIPTION OF OPERATIONS below NIA 103840 05/01/2014 05/01/2015 X WC STATU- OTH- T RV MIT E.L. EACH ACCIDENT $ 100,00 E.L. DISEASE - EA EMPLOYE $ 100,000 E.L. DISEASE - POLICY DMrT I $ 500,00 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, H more apace Is required) City of Fort Collins is named as additional insured. 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 Fort Collins, CO 80522 AUTHORIZED REPRESENTATIVE ©1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009109) The ACORD name and logo are registered marks of ACORD