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Home My WebLink AboutSOUTHPAW PLUMBING LLC - INSURANCE CERTIFICATEi i ® ACORD, CERTIFICATE OF LIABILITY INSURANCE Ilft.� DATE (MM/DDIYYYY) 1 05/06/2019 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 Advantage 1 Insurance CONTACT NAME: Teresa Campa PHONE (720)370-2833 ac No: 720-370-2866 ADDRESS: teresa@advantageoneins.com 90 W. 84th Ave. INSURERS AFFORDING COVERAGE NAIC# Denver, CO 80260 INSURERA: Auto Owners Insurance INSURED Southpaw Plumbing, LLC Jami Reichelt INSURERB: Midwest Family Mutual INSURER C : PO Box 1632 INSURER D : Englewood, CO 80150-1632 INSURER E: INSURER F COVERAGES CERTIFICATE NUMBER: 00000000-0 REVISION NUMBER: 3 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 OF INSURANCE ADDTYPE INSD WVDSUBR POLICY NUMBER MMIDD/YYYY) (MMIDDfYYYYI LIMITS A X COMMERCIAL GENERAL LIABILITY 74188542 05/01/2019 05/01/2020 EACH OCCURRENCE $ 11000,000 CLAIMS -MADE OCCUR DAMAGE TO RENTED PREM SES Ea occurrence) $ 300,000 MED EXP (Any one person) $ 10,000 PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP/OP AGG $ 2,000,000 X POLICY PRI- LOC JECT$ OTHER: B AUTOMOBILE LIABILITY CPCO0560122058 05/01/2019 05/01/2020 Ea accident SINGLE LIMIT $ 1 OOO OOO BODILY INJURY (Per person) $ ANY AUTO OWNED SCHEDULED AUTOS AUTOS ONLY LXX_ HIRED NON -OWNED AUTOS ONLY AUTOS ONLY BODILY INJURY (Per accident) $ PROPERTY DAMAGE$ Per accident A X UMBRELLA LIAB X OCCUR 5229460000 05/01/2019 05/01/2020 EACH OCCURRENCE $ 1,000,000 AGGREGATE $ 1,000,000 EXCESS LIAB CLAIMS -MADE DED RETENTION $ $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE YIN OFFICER/MEMBER EXCLUDED? F (Mandatory in NH) N I A CPC00560122058 05/01/2019 05/01/2020 ER X STATUTE OERH E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE - POLICY LIMIT $ 1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS/ LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more space is required) Workers Comp: Jami Reichelt City of Fort Collins P.O. Box 580 Fort Collins, CO 80522 li/11Y V GLLIY 1 I V I Y 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 U IUtSS-ZU90 AGUKIJ GUKI`UKA I IUN. All rignis reserveo. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD Printed by TMC on May 06, 2019 at 09:50AM