HomeMy WebLinkAboutBERNA ROOFING - INSURANCE CERTIFICATE (2)CERTIFICATE OF LIABILITY INSURANCE
American Family Insurance Company ❑
American Family Mutual Insurance Company, S.I. 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.)
Bernardo Caceres Ella Washington Agency, Inc.
dba Berna Roofing 6525 Gunpark Dr Ste 360
2927 Bassick St Boulder, CO 80301
Fort Collins, CO 80526 (303) 530-3444 (054/309)
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 policies listed below.
COVERAGES
This is to certify that 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 x 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 polices.
POLICY DATE
TYPE OF INSURANCE
POLICY NUMBER
LIMITS OF LIABILITY
EFFECTIVE EXPIRATION
(Mc, Day, Yr) Mo, Day, Yr
Homeowners/
Bodily 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
Farm Liability 8 Personal Liability
Farm/Ranch Liability
Each Occurrence $ '000
Farm Employer's Liability
Each Occurrence $ '000
Statutory «..«.......
Workers Compensation and
Each Accident $ '000
Employers Liability t
Disease - Each Employee $ '000
Disease - Policy Limit $ 000
General Liability
General Aggregate $ 2,000 000
Products -Completed Operations Aggregate $ 2,000,000
IK Commercial General
Personal and Advertising Injury $ 1,000,000
Liability (occurrence)
05-XD7390-04
09/04/2018
09/04/2019
Each Occurrence $ 1,000,000
❑
❑
Damage to Premises Rented to You $ 100,000
Medical Expense (Any One Person) $ 5,000
Businessowners Liability
Each Occurrencett $ '000
Aggregatett $ '000
Liquor Liability
Common Cause Limit $ '000
Aggregate Limit $ '000
Automobile Liability
Bodily Injury - Each Person $ '000
❑ Any Auto
❑ All Owned Autos
Bodily Injury -Each Accident $ DOQ
Property Damage $ '000
❑ Scheduled Autos
❑ Hired Auto
Bodily Injury and Property Damage Combined $ '000
❑ Nonowned Autos
Excess Liability
❑ Commercial Blanket Excess
Each Occurrence/Aggregate $ '000
11
Other (Miscellaneous Coverages)
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / RESTRICTIONS / SPECIAL ITEMS
tThe individual or partners Have
shown as insured elected to
be covered under this policy. ❑ Have not
ttProducts-Completed Operations aggregate
is equal to each occurrence limit and is
included in policy aggregate.
CERTIFICATE HOLDER'S NAME AND ADDRESS
CANCELLATION
City of Fort Collins
Should any of the above described policies be cancelled before the expiration date
thereof, the company will endeavor to mail '( 10 days) written notice to the Certificate
281 N C of le e Ave
g
Holder named, but failure to mail such notice shall impose no obligation or liability of any kind
.
upon the company, its agents or representatives. *10 days unless different number of days
Fort Collins, CO 80524
shown.
This certifies coverage on the date of issue only. The above described policies are
subject to cancellation in conformity with their terms and by the laws of the state of issue.
DATE ISSUED
AUTHORIZED REPRESENTATIVE
09/04/2018
Ella Washington
U-201 Ed. 5/00 Stock No. 06668 Rev. 7/02