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HomeMy WebLinkAbout592927 HASELDEN CONSTRUCTION LLC - INSURANCE CERTIFICATE (3)P52")2a002 ACORC?`� CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDDIYYYY) 06/28/2019 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(les) 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 1-303-534-4567 IRA, Inc. - Colorado Division CONTACT NAME: PHONE T—FAX Extl: I IA/CyNo1: - 17th St Ste 100 E-MAIL denaccounttechs@imacorp.com ADDRESS: rP•com INSURER_(S�_AFFORDING COVERAGE NAIC k INSURERA: VALLEY FORGE INS CO (CNA) 20508 Denver, CO 80202 INSURED Haselden Construction, LLC INSURERB: NATIONAL FIRE INS CO OF HARTFORD(CNA) 20478 INSURER C : CONTINENTAL INS CO (CNA) _ 35289 _ INSURERD:PINNACOL ASSUR 41190 6950 South Potomac Street INSURER E : Centennial, CO 80112 INSURERF: COVFRAGFS CFRTIFICATF NIIMRFR• 56598371 o=%1lclnu auraaocn. 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 A L SUB POLICYNUMBER POLICY EFF MMDDIY POLICY EXP MM/DD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE IT]OCCUR 4028808411 07/01/19 07/01/20 EACH OCCURRENCE $ 1,000,000 PREMISES Ea reu- occurrence $ 1,000,000 X MED EXP (Any one person) $ 15,000 PD Ded: $10, 000 . PERSONAL & ADV INJURY $ 1,000,000 GEN'LAGGREGATE LIMIT APPLIES PER: POLICY � PRO �� ,c LOC JECT LJ GENERAL AGGREGATE_ $ 2,000,000 PRODUCTS-COMP/OPAGG $ 2,000,000 _ _ $ OTHER: B AUTOMOBILE LIABILITY C4028808425 07/01/19 07/01/20 COMBINEDINGLELIMIT a Ea ccidentS $ 1,000,000 BODILY INJURY (Per person) $ X ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Per accident) $ X HIRED X NON -OWNED AUTOS ONLY AUTOS ONLY PROPERTYDAMAGE Per accident) $ $ C X UMBRELLA LIAB X JOCCUR 6042783626 07/01/19 07/01/20 EACH OCCURRENCE $ 2,000,000 AGGREGATE $ 2,000,000 EXCESS LIAR CLAIMS -MADE DED X RETENTION$ 10,000 $ D WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANYPROPRIETOR/PARTNER/EXECUTIVE a OFFICERIMEMBEREXCLUDED? N 1 A 4082635 - CO ONLY 07/01/19 07/Ol/20 X STATUTE ERH E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 (Mandatory In NH) 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, maybe attached If more apace is required) RE: Contractors License V GR111-II,MIG nvwcrt 1,A19L.CLLA I IVN SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City Of Fort Collins THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. BOX 580 AUTHORIZED REPRESENTATIVE Fort Collins, CO 80522-0580 / USA ( / /4 ACORD 25 (20%03) michael. Sheinberg 56598371 ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD O` z LIJ