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HomeMy WebLinkAboutLONG BUILDING TECHNOLOGIES INC - INSURANCE CERTIFICATE/'1 CK" aDr CERTIFICATE OF LIABILITY INSURANCE [_DATE (MM/DDNYYY) 04/30/2015 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 1-303-534-4567 IMA, Inc. - Colorado Division CONTACT NAME: PHONE FAX A/C No n ODRELSS: denaccounttechs@imacorp.com 1705 17th Street INSURERS AFFORDING COVERAGE NAIC 0 Suite 100 INSURERA: CHARTER OAR FIRE INS CO (Travelers Ins Bb615 Denver, CO 80202 INSURED INSURER B: TRAVELERS IND CO 25658 LONG Building Technologies, Inc. INSURERC: TRAVELERS PROP CAS CO OF AMER 25674 INSURERD: ARGONAUT INS CO (Mountain West Agency 19801 5001 South Zuni Street INSURER E : INSURER F: Littleton, CO 80120 COVERAGES CFRTIFICATF N1IMRFR 43721612 RFVICInM Idi IMRFR- 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 ADDL BR POLICY NUMBER EFF MMLIon POLICY MMIDD EXP LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE FXIOCCUR PD: $10, 000 Ded. DTC07PS76683COF15 05/01/15 05/01/16 EACH OCCURRENCE $ 1,000,000 DAMAGE TO R PREMISES Ea occurrence $ 300,000 X X GENT MED EXP (Anyone person) $ 15,000 WY - Stop Gap Incl. PERSONAL & ADV INJURY $ 1,000,000 AGGREGATE LIMIT APPLIES PER: POLICY a PECOT- rx-1 LOC OTHER: GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP/OPAGG $ 2,000,000 $ B AUTOMOBILE X X LIABILITY ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS HIRED AUTOS X NON -OWNED AUTOS DT8107F576683IND15 05/01/15 05/01/16 COMEaaccidentBINiint) SINGLE LIMIT $ 1,000,000 BODILY INJURY (Per person) $ (accident) BODILY INJURY Per $ PROPERTY DAMAGE Per accident $ E C X UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE DTSMCUP7F57668315TIL 05/01/15 05/01/16 EACH OCCURRENCE $ 1,000,000 AGGREGATE $ 1,000,000 DED I X I RETENTION$ 10, 000 $ D D WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNERIEXECUTIVE OFFICER/MEMBER EXCLUDED? IN I (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below I N/A I I WC928028404254-NV,UT,OR, WC928028404234 - CO ONLY /O1/15 05/01/15 05/01/16 05/01/16 X STATUTE ERH E.L. EACH ACCIDENT - $ 500,000 E.L. DISEASE - EA EMPLOYE $ 500,000 E.L. DISEASE - POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required) COMB - HVAC Commercial License SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Fort Collins THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 281 N. College Avenue AUTHORIZED REPRESENTATIVE PO Sox 580 Fort Collins, CO 80526 USA ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD njones2014 43721612 In 00 N W P5260029002 DATE SUPPLEMENT TO CERTIFICATE OF INSURANCE 04/30/2015 NAME OF INSURED: LONG Building Technologies, Inc. Additional Description of Operations/Remarks from Page 1: Additional Information: Installation Floater Coverage: Policy #QT6303E978519TIL15 Eff. Dates: 05/01/2015-05/01/2016; Insurer C: See Above $100,000 Any One Location Limit; $100,000 Per Disaster Limit $100,000 Temporary Location Limit; $100,000 Transit Limit $2,500 Deductible SUPP (05/04)