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Home My WebLink AboutBELFOR PROPERTY RESTORATION - INSURANCE CERTIFICATEAC R ® �- CERTIFICATE OF LIABILITY INSURANCE DATE06 9/2011YYYY) 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 Aon Risk Services Central, Inc. Southfield MI Office CONTACT NAME: PHONE -7122 FAX <800) 363-0105 (A/C. No. Ext): (866) 283 (A/C. No.): E-MAIL ADDRESS: 3000 Town Center Suite 3000 INSURER(S) AFFORDING COVERAGE NAIC # Southfield MI 48075 USA INSURED INSURER A: ACE American Insurance Company 22667 INSURERB: ACE Property & Casualty Insurance Co. 20699 Belfor USA Group. Inc. dba Belfor Property Restoration 5085 Kalamath Street INSURER C: INSURER D: Denver Co 80221 USA INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 570077257395 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. Limits shown are as requested I LTR TYPE OF INSURANCE ADD INS. WVD SUBRI POLICY NUMBER POLICY EFF MM DD/YYYY POLICY EXP MM/DDlYYYY LIMITS A X COMMERCIAL GENERAL LIABILITY HDOG710782b7 /01/2019 0710112020 EACH OCCURRENCE $7 , 000 , 000 DAMA E T RENTED $2 OOO OOO CLAIMS -MADE X❑ OCCUR PREMISES Ea occurrence) , , MED EXP (Any one person) $10 , 000 PERSONAL &ADV INJURY $2,000,000 GENT AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $9,000, 000 POLICY PRO a LOC PRODUCTS - COMPIOP AGG $9,000,000 JECT OTHER. A AUTOMOBILE LIABILITY ISA H09092936 07/01/2019 07/01/2020 COMBINED SINGLE LIMIT Ea accident $5 , 000 , 000 BODILY INJURY ( Per person) X ANYAUTO BODILY INJURY (Per accident) SCHEDULED XIOWNED AUTOS ONLY AUTOS PROPERTY DAMAGE X HIREX NON -OWNED (Perna ciden ONLYAUTOS ONLY B XCQG7153974AO01 07/01/2019 07/01/2020 EACH OCCURRENCE $5,000,000 X UMBRELLA LIAB X OCCUR AGGREGATE $ 5 , 000 , 000 EXCESS LIAB CLAIMS -MADE DED I RETENTION A WORKERS COMPENSATION AND WLRC50799657 07/01/2019 07/01/2020 X STATUTE ORH EMPLOYERS' LIABILITY YIN A05 E.L. EACH ACCIDENT $1, 000 , 000 A ANY PROPRIETOR / PARTNER / EXECUTIVE N NIA SCFC50799669 07/01/2019 07/01/2020 E.L. DISEASE -EA EMPLOYEE $1 , 000 , 000 OFF ICER/MEMBEREXCLUDEI (Mandatory in NH) wI If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT $1, 000 , 000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) RE: Contractor License. City Of Fort Collins is included as Additional Insured as required by written contract, but limited to the operations of the Insured under said contract with respect to the General Liability policy. c d Q N 12 0 2 CERTIFICATE HOLDER CANCELLATION °Z4 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City Of Fort Collins AUTHORIZED REPRESENTATIVE Attn: Contractor Licensing 4 P. North College Avenue c AIL- `% ,� P. o. Box Collins,580 J�_Ycl� Fort ns, co 80522 USA �� ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD