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HomeMy WebLinkAboutHILLSIDE CONSTRUCTION INC - INSURANCE CERTIFICATE (3)ACORN® CERTIFICATE OF LIABILITY INSURANCE �� D /Y) 4/7/2/7/201515 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 Flood and Peterson Corporate Mailing Address: PO BOX 578 Greeley CO 80632 CONTACT K lie Miller CISR NAME: y PHONEN. AIC(970)266-7148 FAX No,, (970) 506-6045 ADDRESS:KMiller@floodpeterson.com INSURER(SI AFFORDING COVERAGE NAIC # INSURERA:BITCO Insurance Companies INSURED Hillside Construction, Inc. 216 Hemlock Street, Suite B Fort Collins CO 80524 INSURERB:P1nnacol Assurance. INSURERC:New Day Underwriting INSURER D: INSURER E : INSURER F: COVERAGES CERTIFICATE NUMBER:CL1S4701961 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 TR TYPE OF INSURANCE DL UBR POLICY NUMBER MMIDPOLIOYEYYY MMLDOfYYY Y LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO 11 PREMISES Ea oc urrence $ 300,000 A CLAIMS -MADE FX] OCCUR CLP3618546 /1/2015 4/1/2016 MED EXP(Any one person) $ 5,000 PERSONAL& ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2,000,000 POLICY X JECT PRO LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident 1,000,000 BODILY INJURY (Per person) $ A ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS 3618545 /1/2015 /1/2016 BODILY INJURY (Per accident) $ X PROPERTY DAMAGE Pe,acade,i $ X NON -OWNED HIRED AUTOS AUTOS Underinsured motorist $ 1,000,000 X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 5,000,000 AGGREGATE $ 5,000,000 A EXCESS LIAB CLAIMS -MADE DED I X I RETENTION$ 10,000 $ 1 FUP2807757 /1/2015 /1/2016 B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) N / A 147214 /1/2015 /1/2016 X WC STATU- O E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYE $ 1 000 000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 1,000,000 A Leased/Rented Equip LP3618546 /1/2015 /1/2016 $50,000 Limit/$500DeJ C Prof. & Poll. Liability ECO045635 04/01/2015 04 / 01/2016 2,000,000/2,000,000 Ea.Occur./Agg DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is required) CERTIFICATE HOLDER CANCELLATION City of Fort Collins P.O. Box 580 Fort Collins, CO 80522-0580 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 K Miller, CISR/KMILLE 10K�/ ACORD 25 (2010/05) INS075 rvmnnci n+ ©1988-2010 ACORD CORPORATION. All rights reserved. Thu ar non namn �nA Innn ao runic}ururl make of ar npr1