Loading...
HomeMy WebLinkAboutMARSHALL BROTHERS CONSTRUCTION LLC DBA G2 ROOFING - INSURANCE CERTIFICATEAC " CERTIFICATE OF LIABILITY INSURANCE FDATE(MM/DDNYYY) 09/19/2018 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 endorsements . PRODUCER CONTACT Bonnie Dyson Stailey Insurance Corporation PHONE Bonnie Dyson 6 FAX (303)759-2960 2084 S. Milwaukee Street Denver CO 80210- ADDRESS: _ _ bonnie@staileycorp.com INSURED Marshall Brothers Construction, LLC dba: G2 Roofing and Construction 6920 S. Jordan Road, Suite H Englewood CO 80112- Mesa Underwriters Specialty Insurance 136838 Pinnacol Assurance kI1190 COVFRAGFS 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 N Irl.T D. 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. iADDLSUBR IE_ _. - - - _ -_..--------- TYPE OF INSURANCE ------ La POLICY EFF POLICY EXP LIMITS ,A X COMMERCIAL GENERAL LIABILITY X X MP00050033001668 09/27/2018 9/27/2019 EACH OCCURRENCE S 1,000,000 CLAIMS -MADE X OCCUR . ._, DAMAGE TO RENTED 'r lF_a_OLGtJ $ 100 000 MED EXP (Any oneperson) $ 5,000 PERSONAL SADVINJURY $ 1,000,000 GENERAL AGGREGATE ------------------__-__------ PRODUCTS-COMP/OPAGG $ --2,O0--,000 $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: X j PRO- II POLICY ,_-__, JECT I�_i LOC $ OTHER AUTOMOBILE LIABILITY i COMBINED SINGLE LIMIT $ BODILY INJURY (Per person) $ j ANY AUTO ALL OWNED F I SCHEDULED AUTOS —.1 AUTOS BODILY INJURY (Per accident) S PROPERTY DAMAGE (Per, id.nil $ IiIFEDAUT05 NON -OWNED AUTOS $ A X UMBRELLA LIAB X OCCUR BE080751085 07/23/2018 09/27/2019 EACH OCCURRENCE $ 1,000,000 AGGREGATE $ EXCESS LIAB CLAIMS -MADE_ DFD RETENTION B'. WORKERS COMPENSATION X4195907 110/01/2018 10/012019 z77OTH- X PER TuTr rp j AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE nFF10ER/MEMBER EXCLUDED9 �I N /A (Mandatory In NH) E.L. EACH ACCIDENT 500,000 E.L. DISEASE - EA EMPLOYEE $ 500,000 DISEASE - POLICY LIMIT _ 500,000 :If yes, describe under DFSCRIPTION OF OPERATIONS belowE.L. I i i DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space is required) I 1 CERTIFICATE HOLDER CANCELLATION Al U59434 City of Fort Collins P,O. Box 580 Fort Collins SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. CO 80522 AUTHORIZED REPRESENTATIVE 1� — 1 Lf' @'wvv-e © 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD