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HomeMy WebLinkAboutMPB CONTRACTORS INC - INSURANCE CERTIFICATEA� OF CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDD/VYYY) E(MMI DfY 019 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 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 Olson & Olson Ltd 5655 S. Yosemite St. #200 CONTACT NAME: PHONE FAX Alc Exit): 303-867-2061 A/C No : 303-867-2074 ADDRIESs: o2@olsonandolson.com Greenwood Village CO 80111 INSURE S AFFORDING COVERAGE NAIC 0 INSURERA: Plnnacol Assurance 41190 INSURED MPBCO-1 MPB Contractors, Inc. 3155 Chambers Road INSURER B: Firemans Insurance Co Of Washington 21784 INSURERC: Continental Casualty Company 20443 INSURERD: Aurora CO 80011 INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: 158194827 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 LTR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DD/YYYY LIMITS B X COMMERCIAL GENERAL LIABILITY CPA322546420 7/1/2019 7/1/2020 EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE OCCUR DAMAGE TO RENTED PREMISES Ea occurrence $ 500,000 MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $ 1,000,000 AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,D00,000 GEN'L POLICY PRO LOC JECT PRODUCTS - COMP/OP AGG $ 2,000,000 $ OTHER B AUTOMOBILE LIABILITY CPA322546420 7/12019 7/1/2020 COMBINED SINGLE LIMIT Ea accident $ 1 000 ODD BODILY INJURY (Per person) $ ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS I BODILY INJURY (Per accident) $ HIREDAUTOS X NON -OWNED AUTOS PROPERTY DAMAGE Per accident $ B X UMBRELLA LIAB X OCCUR CPA322546420 7/12019 7/1/2020 EACH_ OCCURRENCE $5,000,000 AGGREGATE $ 5,000,000 EXCESS LIAB CLAIMS -MADE DED X I RETENTION $ 0 $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N 4058803 7/12019 7/12020 PER OTH- STATUTE I ER EACH ACCIDENT $ 500,000 ANY PROPRIETOR/PARTNER/EXECUTIVE El OFFICER/MEMBER EXCLUDED? NIA N /A E.L. DISEASE - EA EMPLOYE $ 500, Do0 (Mandatory in NH) If yes, describe under DESCP.!PTON OF OPERATIONS below E.L. DISEASE - POLICY LIMIT 1 $ 500.000 C Installation Floater 5078811854 7/11/1019 7/12D20 Jobsite $1,000,000 Cause of Loss Form. Special Deductible' $1,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Certificate Holder and those listed below(if any) are Additional Insureds as respects General Liability and Umbrella Liability on a Primary and Non -Contributory basis, and Auto Liability only if required by written contract or agreement and coverage applies only as respects work performed by the Insured for the Additional Insureds. All coverage terms, conditions, and exclusions of the policy apply. The Worker's Compensation, General Liability, Auto Liability, and Umbrella Liability policies include a Waiver of Subrogation in favor of the Additional Insureds only if required by written contract or agreement. Contractor's License. LIMI[I Ir II.A 1 C r1VLLJr_M I.Ar4L r_LLA I IVIV City of Fort Collins P.,O. 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 1;�4 rf`41�� ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD