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Home My WebLink About432047 ALL PHASE RESTORATION - INSURANCE CERTIFICATE (2)ALLPH-0 OP ID: MB Alk R CERTIFICATE OF LIABILITY INSURANCE DA04/01/2015TE V) oarol/2o15 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 Renaissance Insurance Group P O Box 478 101 E Main Street Windsor, CO 80550 Erich E. Ehrlich E. Ehrlich INSURER A: Nautilus Insurance INSURED All Phase Restoration, Inc INSURER 0: Pinnacol Assurance 7356 Greenridge Road Unit C Windsor, CO 80550 INSURERC: INSURER D : INSURER E : INSURERF: 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. NSR LTR TYPE OF INSURANCE POLICY NUMBER POLICY EFF MMIDOlYVYY POLICY EXP MM/DDIYYYY Lam A X COMMERCIAL GENERAL LIABILM CLAIMS -MADE T OCCUR ECP10040410 X ECP2007209-12 BLANKET ADDITIONAL INSD 10/22/2014 10/22/2015 EACH OCCURRENCE $ 2,000,00 PREMISES Eaoocmance $ 100,00 X MEDEXP(Any omperson) $ 5,00( X ENV20040906 PERSONAL BADVINJURY $ 2,000,00 WAIVEROFSUBROGATION GEN'L AGGREGATE LIMIT APPLIES PER: POLICY F 1 JECT LOC GENERAL AGGREGATE $ 2,000,00 PRODUCTS - COMP/OP AGO S 2,000,00 r $ OTHER I I AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident = BODILY INJURY (Par person) S ANY AUTO WA ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY Per accident) ( ) $ NON -OWNED HIRED AUTOS AUTOS PROPERTY DAMAGE Peraccltlent $ U�EI I W1B X OCClX2 EACH OCCURRENCE S 1,000,00 A X CLaMSLtADE FFX2007212-12 10122/2014 10/2212015 AGGREGATE S 1,000,00 DEDEssLIAe DED RETENTION$ $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNERIEXECUTIVE YIN OFFICER/MEMBER EXCLUDED? ❑NIA 107070 03/01/2015 03/01/2016 X I STATUTE I ER E.L. EACH ACCIDENT $ 1,000,00 E.L. DISEASE - EA EMPLOYEd $ 1,000,00 (Mandatory In NH) If yas. describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 1,000,00 A CPL ECP200720902 10/22/2014 10/22/2015 PER OCCUR 1,000,00 AGGREGATE 1,000,00 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space is required) Fax: 970-224-6134; dclapp@fcgov.com Subject to_policy conditions, endorsements and exclusions. The City ofpFort Collins, its officers, agents and employees are included as Additional insured as respects General Liability. liMlal.CLL.N I Ium CITY OF 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. P O Box 580 Fort Collins, CO 80522 AUTHORIZED REPRESENTATIVE �ls�.ar'ti Zrrau �.Ika�-&lap V 19t5t5-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD CERTIFICATE OF LIABILITY INSURANCE American Family Insurance Company ❑ American Family Mutual Insurance Company if selection box is not checked. 6000 American Pky Madison, Wisconsin 53783-0001 Insured's Name and Address Agent's Name, Address and Phone Number (Agt./Dist.) All Phase Restoration LLC Paul A Chacon 7355 Greenridge Rd Ste C 212 N 2nd St Windsor, CO 80550 La Salle, CO 80645 (970) 284-5237 (137/309) This certificate Is issued as a matter of Information only and confers no rights upon the Certificate Holder. This certificate does not amend, extend or alter the coverage afforded by the DO11cles listed below. COYEftAGES k6u This is to certify that polkas of insurance listed lielow have been Issued to the Inured named above for the polity period indicated, notwithstanding any requirement term or u'ondltlon of eny cot 0 let or other document with respect to which this certificate may, be issued or may porter, the insurance afforded by the pellet" described herein is subject to all the terms, exclusions, and conditions of such policies. POLICY DATE TYPE OF INSURANCE POLICY NUMBER LIMITS OF LIABILITY EFFFDCTIVE PIRATION (Mo, ay, Vq o, a . Yr) Homeowners) Boddy Injury and Property Damage Mobilehomeowners Liability Each Occurrence $ .000 Boatowners Liability Bodily Injury and Property Damage Each Occurrence $ 000 Personal Umbrella Liability Bodily Injury and Property Damage Each Occurrence $ '000 Fan Liability & Personal Liability Farm/RanchLiability Each Occurrence $ '000 Farm Employees Liability Each Occurrence $ 000 Statutory -..— -- Workers Compensation and Each Accident $ 000 Disease - Each Employee $ 000 Employers Liabilityt Disease - Policy Lund $ '000 General Liability GenerahAggregate $ '000 ❑ Commercial General Products-completedOperatrons Aggregate $ '000 Personal and Advertising Injury $ '000 Liability(occurrence) ❑ Each Occurrence $ '000 ❑ Damage to Premises Rented to You $ '000 Medical Expense (Any One Person) $ 1000 EachOccurrencett $ '000 Businessowners Liability Aggregatett $ '000 Common Cause Limit $ '000 LigUOf Liability Aggregate Limn $ '000 Automobile Liability Boditylnjury- EachPerson $ 1,000,000 0 Any Auto ❑AIIOwnedAutos 9oddyln)ury- Each Accident $ 1,000,000 ❑x Scheduled Autos 05-XM2061-01 02101/2015 02/01/2016 Property Damage $ 1,000,000 O Hired Auto Bodily Injury and Property Damage Combined $ 2,000,000 ❑x Nonowned Autos El Excess Liability ❑ Commercial Blanket Excess Each Occurrence/Aggregate $ .000 El Other (Miscellaneous Coverages) DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / RESTRICTIONS / SPECIAL ITEMS tihe individual Or partners ❑Have The City of Fort Collins, its officers and employees are added as Additional shown as insured elected to be covered under this policy ❑ Have not insured as respects to the Automobile Liability ttProducts-Completed Operators aggregate is equal to each occurrence limit and n included in policy aggregate. City of Fort Collins x Should any d the above described policies be cancelled before the expiration date thereof, the company will endeavor to mail '( days) written notice to the Certificate PO Box 580 all impe no obligation or liability of any kind Holder named, but fatture to mail such not" ahimpose *10 upon the company, its agents or representatives. days unless different number of days Fort Collins, CO 80522-0580 shown, LJ This certifies Coverage on the data of issue only. The shove described policies are subject to cancellation in conformity with their terms and by the laws f the state of Issue. DATEISSOED AUTHO REPR IVE 04/01/2015--� 11-9n1 FA. 5/00 )ock No. 06668 Rev. 7/02