HomeMy WebLinkAboutCALVIN TURNER ROOFING LLC - INSURANCE CERTIFICATEa 711,15/2019
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CERTIFICATE OF LIABILITY INSURANCE
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: Stephanie Van Buskirk
Arthur J. Gallagher Risk Management Services, Inc.PHONE 719-544-1111 FAX c No : 719 545 5120
1515 Fortino Blvd Suite 200 E-MAIL
Pueblo CO 81008 : ste hanie vanbuskirkinajg.com
INSURED
Calvin Turner Roofing LLC
3128 West 12th St.
Pueblo, CO 81003
INSURER) AFFORDING COVERAGE
INSURER A: Cincinnati Insurance Company
CALVTUR-01 INSURER 8 : Plnnacol Assurance Company—
INSURER C;-,Cincinnati Specialt Underwriters Ins
INSURER D :
CnVFRAI':Ffi CFRTIFIr ATF NIIMRFR- 1l17rri7777R RFVISIAN NIJMRFR-
NAIC #
10677
41190
13037
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.
ILT R --TYPE OF INSURANCE TifN9Q iSU 13 POLICY NUMBER MMLICY DD VYYY MFF MILDI D YYYY LIMITS
LTR
C
X COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE (X OCCUR
CSU0109004
2/1/2019
2/1/2020
EACH OCCURRENCE
PREMISES 4cQurrgn ®).__.-
$1,000,000
$100,000
X ; CSGA4087
X CSGA437
MED EXPJAr�t one persons
PERSONAL 8 ADV INJURY
GENERAL AGGREGATE
$ 5,000 __—
$110001000
$ 2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
X 1 POLICY PRO-
_._.. JECT LOC
PRODUCTS_-COMP/OP AGG _
$ 2,000,000
OTHER:
i $
A
AUTOMOBILE LIABILITY
ENP0473293EBA0473293
2/1/2019 2/1/2020 COMBINED SINGLE LIMIT
Ea_accident
$1,0o0,o00
X ANY AUTO
BODILY INJURY (Per person)
$_..—_____—_._.
OWNED SCHEDULED
AUTOS ONLY AUTOS
HIRED NON -OWNED
AUTOS ONLY AUTOS ONLY
BODILY INJURY (Per accident)
PROPERTY DAMAGE
_f er_accident)
'
C
X UMBRELLA LIAR
X
OCCUR
CSU0124995 2/1/2019 2/1/2020
EACH OCCURRENCE _ _
$1,000,000
EXCESS LIAB
LA
AGGREGATE
$1,000,000
$1,000,000
DED ''.. RETENTION $
B WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY YIN
ANYPROPRIETORIPARTNEP,EXECUTIVE
4128974 2/1/2019 2/1/2020 1 PER OTH-
.EACHACCIDENT
$1,000,000
OFFICERWEMBER EXCLUDED?
(Mandatory In NN)
NIA
�EL71111SEASE-EA EMPLOYEE
$1,000,000If
yes. describe under
DESCRIPTION OF OPERATIONS below
.L. DISEASE - POLICY LIMIT
I $ 1,000,000
A Leased/Rented Equip
ENP0473293EBA0473293 I 2/1/2019 2/1/2020 Limit
40,000
DESCRIPTION OF OPERATIONS 1 LOCATIONS/ VENCLES (ACORD 101, Additional Remarks Schedule. may be attached if more space is required)
Roofing Contractor
CERTIFICATE HOLDER CANCELLATION
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
PO Box 580 AUTHORIZED REPRESENTATIVE
Fort Collins CO 80526
U 1988-2015 ACORD CORPORA I ION. All rights reserves.
ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD
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