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FOOTHILLS COMMERCIAL BUILDERS INC - INSURANCE CERTIFICATE
ACORL7® CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 2/7/2019 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 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 Olson & Olson Ltd 5655 S Yosemite Street #200 Greenwood Village CO 80111 CONTACT NAME: alcNr o xt : 303-867-2055 FAX, No): 303-867-2074 ADDRESS: o2@olsonandolson.com INSURERS AFFORDING COVERAGE NAIC # INSURER A: Westfield National Ins Co 24120 INSURED FOOTCOM-01 Foothills Commercial Builders, Inc. INSURER B : Pinnacol Assurance 41190 7241 S. Fulton St. INSURERC: INSURERD: Centennial CO 80112 INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: 2031171248 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. I LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER EFF MM/LDDY EXP MM/DDY/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY CMM012296D 1/1/2019 1/1/2020 EACH OCCURRENCE $1,000,000 CLAIMS -MADE LXI OCCUR DAMA T RENTED PREMISES Ea occurrence $ 500,000 MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $ 1,000,000 AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 GEN'L POLICY a JJE � LOC PRODUCTS -COMP/OPAGG $2,000,000 $ OTHER: A AUTOMOBILE LIABILITY CMM012296D 1/1/2019 1/1/2020 COMBINED SINGLE LIMIT Ea accident)1 $ 000 000 BODILY INJURY (Per person) $ ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ X HIRED AUTOS X NON -OWNED AUTOS PROPERTY DAMAGE Per accident $ A X UMBRELLA LIAB X OCCUR CMM012296D 1/12019 1/1/2020 EACH OCCURRENCE $ 5,000,000 AGGREGATE $ 6,000,000 EXCESS LIAB _ CLAIMS -MADE DED X7 RETENTION $ a $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N 4197966 1/12019 1/12020 X PER OTH- STATUTE I ER ANY PROPRIETOR/PARTNER/EXECUTIVE F OFFICER/MEMBER EXCLUDED? N / A E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYE $ 1,000,000 (Mandatory in NH) If yec. deccribe sander DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT 1 $1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Certificate Holder and those listed below(if any) are Additional Insureds as respects General Liability and Umbrella Liability on a Primary and Non -Contributory basis, and Auto Liability only if required by written contract or agreement and coverage applies only as respects work performed by the Insured for the Additional Insureds. All coverage terms, conditions, and exclusions of the policy apply. The Worker's Compensation, General Liability, Auto Liability, and Umbrella Liability policies include a Waiver of Subrogation in favor of the Additional Insureds only if required by written contract or agreement. Contractors License. CERTIFICATE HOLDER CANCELLATION City of Fort Collins P.O. 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 ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD