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CHAMPION WINDOW CO OF FORT COLLINS LLC - INSURANCE CERTIFICATE (3)
KMULLINS CHAMPIO-01 ACORO" CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD YYYY) 11/30/2018 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 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 Da ton/ Assured Partners NL y 8163 Old Yankee Street, Suite D Dayton, OH 45458 CONTACT NAME., - PHONE (A/c, No, Ezt): (937) 435-4788 (FAX vc, No):(937) 435-7395 ADDRE : INSURERS AFFORDING COVERAGE NAIC # INSURER A: Liberty Insurance Corporation 42404 INSURED INSURER B : Liberty Mutual Fire Insurance Co 23035 INSURER C : Cincinnati Insurance Company 10677 Champion OPCO, LLC Champion Window Co. of Ft. Collins, LLC 5850 Byrd Drive INSURER D: Sentry Insurance a Mutual Company 24988 Loveland, CO 80538 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 LT TYPE OF INSURANCE ADDL INSD SUBR WVD POLICY NUMBER POLICY EFF M/DD/YYYY POLICY EXP MM/DDIYYYY LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE � OCCUR TB7-Z91-461753-038 12/01/2018 12/01/2019 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED PREMISES Ea occurrence) 100,000 $ MED EXP An one person)$ 5,000 PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER. POLICY FX� PRO- � LOC OTHER GENERAL AGGREGATE $ 2'000,000 PRODUCTS - COMP/OP AGG $ 2,000,000 STOP GAP OH WA $ 1,000,000 B AUTOMOBILE LIABILITY X ANY AUTO OWNED SCHEDULED AUTEO�S ONLY AUTOS AUTOS ONLY AUOTOS OWNED AS2-Z91-461753-018 12/01/2018 12/01/2019 Ea acINED ccdent SINGLE LIMIT $ 1,000,000 BODILY INJURY Perperson) $ BODILY INJURY Per accident $ PROPERTY DAMAGE er accident (Per. $ C UMBRELLA LIAB EXCESS LAB X OCCUR CLAIMS -MADE EXSO464308 12/01/2018 12/01/2019 EACH OCCURRENCE $ 10,000,000 X AGGREGATE $ 10,000,000 rlDED I X I RETENTION $ $ D WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN PROPRIETOR/PARTNER/EXECUTIVEANY OFFICER/MEMBER EXCLUDED? � (Mandatory in NH) IT yes, describe under DESCRIPTION OF OPERATIONS below NIA 90-16232-01 12/01/2018 12/01/2019 X PTRT T ER E.L. EACH ACCIDENT 1,000,000 $ E.L. DISEASE - EA EMPLOYE $ 1,000,000 E.L. DISEASE - POLICY LIMIT 1,000,000 $ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) City of Ft Collins PO Box 580 Fort Collins, CO 80522-0580 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 p e, A ACORD 25 (2016103) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD