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HomeMy WebLinkAboutGF TECHNOLOGIES INC DBA COMPLETE BASEMENT SYSTEMS - INSURANCE CERTIFICATECOMPBAS-01 EBIELKIEWICZ ,ACORO CERTIFICATE OF LIABILITY INSURANCE FDATE (30/2/2 Y01 08/308 8 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 have ADDITIONAL INSURED provisions or 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 CONTACT Jennifer Donohue NAME: Forsberg Engerman Co PHONE FAX 3575 S Sherman St (Arc, No, Ext): (303) 762-1717 107 (A/C, No):(303) 762-1733 Englewood, CO 80113 ADDARIEs :Jennifer@forsberg-engerman.com INSURED GF Technologies Inc dba Complete Basement Systems 11795 E 45th Ave Denver, CO 80239 B:EMC Insurance Companies D: f-MICD A!_CC !`CDTICIP`ATC All IAARCD• AF\/ICIr%Kl All IRARFI7• 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 TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF PMMIDDfYYY)OOLICY EXPLTR LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE X OCCUR X 103GL001969301 08/30/2018 08/30/2019 DAMAGE TO RENTED PREMI E Ea occurrence 50,000 $ MED EXP (Any one person $ PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY F_x1 JECT LOC PRODUCTS - COMP/OP AGG $ 2,000,000 $ OTHER: B AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT a accident 1,000,000 $ X BODILY INJURY Perperson) $ ANY AUTO 5E33689 08/30/2018 08/30/2019 BODILY INJURY Per accident $ OWNED SCHEDULED AUTOS ONLY AUTOS X PROPERTY DAMAGE Per accident $ HIRED X NON -OWNED AUTOS ONLY AUTOS ONLY A X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 1,000,000 AGGREGATE $ 1,000,000 EXCESS LIAB CLAIMS -MADE AUX419519001 08/30/2018 08/30/2019 DED I RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROFRiETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? u (Mandatory in NH) N / A PER OT H- TAT TE E E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYE -- $ E.L. DISEASE - POLICY LIMIT If yes, describe under DESCRIPTION OF OPERATIONS below $ B Equipment Floater 5C33689 08/30/2018 08/30/2019 Included B Property 5A33689 08/30/2018 08/30/2019 BPP 780,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) City of Fort Collins is named as an additional insured with respect to general liability per CG2010 04113 as required by contract. RECEIVED SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Fort Collins THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Ci Citn: Kaye Mathes SEP U 4 7018 ACCORDANCE WITH THE POLICY PROVISIONS. PO Box 580 Fort Collins, CO 80522 AUTHORIZED REPRESENTATIVE City Manager's Office � Mu"t) i ACORD 25 (2016103) © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD