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HomeMy WebLinkAboutFRAILEY ROOFING LLC - INSURANCE CERTIFICATE (3)FRAIROO-01 PAULAW ACQR� CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DDlYYYY)4/9/2019 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 Forsberg Engerman Company an affiliate of Mountain West Insurance & Financial Services, LLC 3575 S Sherman Street CONTPaula Weeks _NAMEACT PHONE, FAX A cNo, EXt): (303) 762-1717 A c, No):(303) 762-1733 E-MAIL paulaw@mtnwst.com INSURERS AFFORDING COVERAGE NAIC # Englewood, CO 80113 INSURER A: The Cincinnati Specialty Underwriters Insurance Company 13037 _ INSURED INSURER B: Cincinnati Insurance Company 10677 INSURER C : Pinnacol Assurance 41190 Frailey Roofing LLC INSURER D : 703 Anderson St Castle Rock, CO 80104 INSURER E 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 TYPE OF INSURANCE ADDL SUER POLICY NUMBER POLICY EFF POLICY EXP YY LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE I X] OCCUR CS00055230 2/14/2019 2/14/2020 TO DAMAGEPREMISES (RENTED $ 10 MED EXP An one person)$ 5,000 ,000 PERSONAL & ADV INJURY $ 11000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRO ❑ LOC X POLICY 7 JECT GENERAL AGGREGATE $ 2,000,000, PRODUCTS - COMP/OP AGG $ 2,000,000 $ OTHER: B AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 BODILY INJURY Perperson) X ANY AUTO ENP0483534 4/9/2019 4/9/2020 BODILY INJURY Per accident $ OWNED SCHEDULED AUTOS ONLY AUTOS X HIRED X NON- TED AUTOS ONLY AUTOS ONLYa. Per PERTY DAMAGE $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ HCLAIMS-MADE AGGREGATE $ EXCESS LIAB DED I I RETENTION $ $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PXCLUDE/EXECUTIVE 4;1/2019 .:/ir020 PER OTH- X I TATUTE ER E.L. EACH ACCIDENT 1,uiiG,oCt, E.L. DISEASE - EA EMPLOYEE 1,000,000 $ in N )EXCLUDED? ❑ (Mandatory in NH) (Mandatory N 1 A E.L. DISEASE - POLICY LIMIT 1,000,000 $ If yes, describe under DESCRIPTION OF OPERATIONS below B Equipment Floater ENP0483534 4/9/2019 4/9/2020 Installation Floater 30,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) I I CERTIFICATE HOLDER CANCELLATION I SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City Of Fort Collins THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN y ACCORDANCE WITH THE POLICY PROVISIONS. P.O. Box 580 Fort Collins, CO 80522 AUTHORIZED REPRESENTATIVE ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD