HomeMy WebLinkAboutBUILDINGS BY DESIGN LLC - INSURANCE CERTIFICATEQC �M DATE (MUDD.!YYYY)
CERTIFICATE OF LIABILITY INSURANCE 9/24l2018
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
NAME: Scott Anderson, CIC
Commercial Risk Solutions PHONEFAx
6600 E Hampden Ave Ste 200 EMAIL • 303-996-7833 A;c No : 303-757-7719
Denver CO A s sanderson crsdenver.com
INSURERS) AFFORDING COVERAGE _ _ _ .-_ NAIC
INSURER A! Westfield Insurance 24112
INSURED BUILD-6
Buildings By Design, LLC.
18163 County Road 26
Brush CO 80723
INSURER B : Plnnacol Assurance
_ _
INSURER C :
INSUREgD:
INSURER E :
41190
_
INSURER F :
CnVFRAGFS CERTIFICATE NUMBER: ss77dS017 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.
sm
ILTR - TYPE OF INSURANCE = wvn POLICY NUMBER POLICY EFF POLICY/1EXP ' LIMITS
A
X i COMMERCIAL GENERAL LIABILITY
Y
TRA3658OW
211012DIS
2/10/2019
EACH OCCURRENCE
$1.000,000
CLAIMS -MADE a OCCUR
DAMAGE TO RENti`ED ' -___._
PREMISES (Ea occurrence)
._ _.._ _ ..
$ 500,000
MED EX_P (Any one son)
$ 5,000
PERSONAL & ADV INJURY
$1,000,000
GENt AGGREGATE LIMIT
MIT APPLIES PER:
GENERAL AGGREGATE
$ 2,000,000
1 POLICY X JE � LOC
PRODUCTS - COMP/OP AGG
$ 2,000,OD0
$
OTHER'
i
A
AUTOMOBILE LIABILITY
Y
TRA3658080
2110/2018 2,1012019
SINGLE LIMIT
a accident)
$1 000000
[COMBINED
ODILY INJURY (Per person)
X' ANY AUTO
$
OWNED SCHEDULED
AUTOS ONLY ;AUTOS
BODILY INJURY (Per accident)
$
HIRED NON -OWNED
X AUTOS ONLY X AUTOS ONLY
PROPERTY DAMAGE
(SPer accident
$
Broadened Pollution
$Included
A
X
UMBRELLA LIAB X i OCCUR
TRA3858080
2; t0/2018
2i 10/2019
EACH OCCURRENCE
--.—.. T-- — - - —
$ 5.000,000
- -
EXCESS LIAB CLAIMS -MADE
AGGREGATE
$ 5.000,000__„
_
DED X RETENTION
$
B
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY
i ANYPROPRIETORiPAP.TNER:EXECUTIVE YY"
4073732
10A/2018
1011/2019
X OT
TA TUTE,
— .. .._.R
E.L. EACH ACCIDENT
$500,000
�OFFICERrMEMBEREXCWDED7
NIA
(Mandatory In NH)
E.L. DISEASE - EA EMPLOYEEI
$ 500,000
E.L. DISEASE - POLICY LIMIT
$ 500,000
M yes, describe under
DESCRIPTION OF OPERATIONS below
A Inland Marine
1 EquipmentfACV/Special
TRA3658080
i
2.1012018
2/10/2019
RenttLeased 50,000
Deductible 500
I
DESCRIPTION OF OPERATIONS, LOCATIONS! VEHICLES (ACORD 101. Additional Remarks Schedule. may be attached if more space is required)
The City of Fort Collins, its officers, agents and employees included as additional insured for ongoing operations on the General Liability and included as
additional insured on the Auto Liability with respect to operations of the named insured for the certificate holder as required by written contract. All policy terms,
conditions and exclusions apply.
r`C92TIFIr`ATF Mnl nPO CANCFI I ATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
City of Fort Collins Financial Services Purchasing Division
215 N Mason Street 2nd Floor
Ft. Collins CO 80522
AUTHORIZED REPRESENTATIVE
U 1966-Z015 ACUHU cVHFUKA I Ivry. An rigntS reserved.
ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD