Loading...
HomeMy WebLinkAboutCB SIGNATURE HOMES LLC - INSURANCE CERTIFICATE (4)____8*i CBSIGNA-01 SLUNDER 144coRo CERTIFICATE OF LIABILITY INSURANCE FDAT5/7/2 D/YYYY) S/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 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 NAME CT Shelly Lunder PFS Insurance Group PHONE FAX 4848 Thompson Parkway Suite 200 (AX, No, Exq: _ I (A/C, No):(970) 635-9401 Johnstown, CO 80534 n'DOAIIL shellyl@mypfsinsurance.com INSURED CB Signature Homes, LLC 35333 County Rd 37 Eaton, CO 80615 c : Pinnacol Assurance Co COVFRArFR CFRTIFICATF NIIMRFR• RFVIRIrIAI All IMRFD• 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 R POLICE LTR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER Y FF POLICY EXP LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE I X I OCCUR AGGREGATE LIMIT APPLIES PER: POLICY X PEef El LOC OTHER: X GLP011327407 1/3/2019 1/3/2020 EACH OCCURRENCE $ 31000,000 DAMAGE TO RENTED PREM11 ES (Ba_Occurrence 100,000 $. MED EXP An one- Pe—L —_ 51000 --�_Y _arson PERSONAL & ADV INJURY _$ $ 3,000,000 $ 3,000,000 $ 3,000,000 GEN'L GENERAL AGGREGATE PRODUCTS - COMP/OP AGG B AUTOMOBILE LIABILITY ANY AUTO _ OWNED 1SCHEDULED AUTOS ONLY X AUTOS HI X NON-OWNEg AUWS ONLY AUTOS ONL 5144585301 1/3/2019 1/3/2020 C OMBINEa accide SINGLE LIMIT $ 1,000,000 $ - $ $ BODILY INJURY (Per person) _ X BODILY INJURY (Per accident P�20PERR�AMAGE er accident UMBRELLA LIAB OCCUR EXCESS UAB HCLAIMS-MADE DE D RETENTION $ EACH OCCURRENCE $ $ AGGREGATE C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y / N OFFICER/MEMBER EXCLUDED? h andatory in N I) If yes, describe under DESCRIPTION OF OPERATIONS below NIA 4156397 6/1/2019 6/1/2020 SPTERTU OTH- E.L. EACH ACCIDENT 1,000,000 $ E.L. DISEASE - EA EMPLOYEE $ 1,��>D'��� E.L. DISEASE - POLICY LIMIT 1 0�0,000 ' 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. laK I It- l(:A-It: -HVLDtK CANCELLATION 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 ACORD 25 (2015103) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD