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Home My WebLink AboutCB SIGNATURE HOMES LLC - INSURANCE CERTIFICATE (3)CBSIGNA-01 SLUNDER AL O^ �- CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD 1;MMIDD/YYYY) 9 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 PFS Insurance Group 4848 Thompson Parkway Suite 200 N RMNTEACT Shelly Lunder PHONE FAX JAIC, No, Ext : AIC, No :(970) 635-9401 Johnstown, CO 80534 E-MA'L . shellyl@mypfsinsurance.com INSURERS AFFORDING COVERAGE NAIC # INSURER A: National Builders Insurance INSURED INSURER B: Owners Insurance Company 32700 INSURER C : Pinnacol Assurance Co 41190 CB Signature Homes, LLC 35333 County Rd 37 Eaton, CO 80615 INSURER D INSURER E INSURER F : COVERAGES 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 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 T TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF (POLICY E P LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE [:�] OCCUR X GLP011327407 1/3/2019 1/3/2020 EACH OCCURRENCE $ 3,000,000 DAMAGE TO RENTED occurrence)EMISES (Ea $ 100,000 MED EXP (Any one erson $ 5,000 PERSONAL 6 ADV INJURY $ 3,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY ❑X JECT LOC GENERAL AGGREGATE $ 3,000,000 PRODUCTS - COMP/OPAGG $ 3,000,000 COMBI(Ea accrNED SINGLE LIMIT $ 1,000,UIIU B OTHER: AUTOMOBILE LIABILITY BODILY INJURY Perperson) $ ANY AUTO OWNED X SCHEDULED AUTOS ONLY AUTOS X AUTOS ONLY X AUTOS ONLD 5144585301 1/3/2019 1/3/2020 BODILY INJURY Per accident $ Pe�accitlent AMAGE $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DED I I RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE YIN QFFICE 0 Y fn NH) EXCLUDED? ❑ an, des I NH If yes, describe under DESCRIPI ION OF OPERATIONS below X PER OTH- TE ER $ C N / A 4156397 6!1/2018 6/1/2019 E.L. EACH ACCIDENT $ 100,000 E.L. DISEASE - EA EMPLOYEE $ 100,000 E.L. DISEASE - POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required( If required by written contract, the Certificate Holder is included as Additional Insured for ongoing operations under General Liability. City of Fort Collins PO Box 580 Fort Collins, CO 80522 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ""---- %__ —, V 19S8-Z015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD