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HomeMy WebLinkAboutKLM CONSTRUCTION INC - INSURANCE CERTIFICATEACORD® CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DDNYYY) 05/14/2019 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 CONTACT NAME: Tina Messer PHON o (720)370-2833 FAX No: 720370-2866 Advantage 1 Insurance E-MAIL ADDRESS: tina@advantageoneins.com 90 W. 84th Ave. Denver, CO 80260 INSURERS AFFORDING COVERAGE NAIC9 INSURER A; Midwest Family Mutual INSURED INSURER B: Travelers INSURERC: KLM Construction Inc. INSURER D : 7000 W 14th Ave Lakewood, CO 80214 INSURER E: INSURER F : COVERAGES CERTIFICATE NUMBER: 00000000-434806 REVISION NUMBER: 83 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 LTR .TYPE OF INSURANCE ADDL,S VD POLICY NUMBER Y EXP MMIDPOLID/YYYY MMID LIMITS A X COMMERCIALGENERAL LIABILITY CLAIMS -MADE OCCUR CP000560116085 09/15/2018 09/15/2019 EACH OCCURRENCE $ 1 000 000 DAMAGE TO RENTED PREMISES Ea occurrence $ 50 000 GEN'L MED EXP (Any one person) $ Excluded PERSONAL &ADV INJURY $ 1,000,000 AGGREGATE LIMIT APPLIES PER: PRO-- LOC POLICY Fj] JECT OTHER: GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP/OP AGG $ 2,000,000 $ A AUTO MOBILE LIABILITY ANY AUTO OWNED SCHEDULED AUTOS ONLY X AUTOS HIRED NON -OWNED X AUTOS ONLY X AUTOS ONLY CPCO0560116085 09/15/2018 09/15/2019 COMBINED EaaaccidentSINGLELIMIT) $ 1.000.000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE Peracddent $ A X UMBRELLA LIAB EXCESS LIAB � OCCUR CLAIMS-MADE CPCO0560116085 09/15/2018 09/15/2019 EACH OCCURRENCE $ 8,000,000 AGGREGATE $ 8,000,000 DIED I X RETENTION $ 10000 $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICERIMEMBER EXCLUDED' ❑ (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N/A, CPC00560122177 05/13/2019 05/13/2020 X I PER OTH- STATUTE ER E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE- EA EMPLOYEE $ 1,000,000 $ 1,000,000 E.L. DISEASE- POLICY LIMIT B Employee Theft bond 106825317 10/30/2018 10/30/2019 $1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) L,LK I II` -ILA I t r1ULUtK l.A1V l.CLLA I IUIY City of Fort 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 ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD Printed by TMM on May 14, 2019 at 01.53PM