HomeMy WebLinkAboutSTELLAR RESTORATION SERVICES LLC - INSURANCE CERTIFICATEACOR" CERTIFICATE OF LIABILITY INSURANCE
DATE (MMlDD/YVYV)
7/19/2019
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
USI Southwest
Katy Freeway, Suite 500
Houston TX 77024
CONTACT
NAME: Christian Gonzales
PHO9811 .Ertl• 713-490-4600 (� No): 713.490-4700
E-MAIL
ADDRESS: christian. Onzale5 usi.com
INSURERS AFFORDING COVERAGE
NAIL S
INSURER A: Burlington Insurance Company
23620
INSURED STELLRES3
Stellar Restoration Services LLC
10497 Town and Country Way, Suite 930
INSURERS: Nationwide Insurance Company of America
25453
INSURER c :Federal Insurance Company
20281
INSURERD: Texas Mutual Insurance Company
22945
Houston TX 77024
INSURER E: Argonaut Insurance Company
19801
INSURER F
aiRXeA'aaifl\►l-1yTjL T..!
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.
WSIR
TRR
TYPE OF INSURANCE
ADDLSUBR
pOUCY NUMBER
MOLICY EFF MIDD MPOUCY MIDD EXP yYyJ
LIMITS
A
X COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE XOCCUR
449BW52815
7/19/2019
7/19/2020
EACH OCCURRENCE
$1,000,000
DAMAGE TO RENTED
PREMISES Me occurtence
$ 100,000
MED EXP (Any one person)
$
PERSONAL S ADV INJURY
$1.000,000
GENL
AGGREGATE LIMIT APPLIES PER:
1K 7
GENERAL AGGREGATE
$2.000.000
PRODUCTS -COMP/OPAGG
$2.000,000
POLICY JETCTT LOC
$
OTHER:
B
AUTOMOBILE LIABILITY
SAP03009374588
7/19/2019
7/19/2020
Ea BINEDtSINGLE LIMIT
$1,000,000
X ANY AUTO
BODILY INJURY (Per person)
$
OWNED SCHEDULED
' AUTOS ONLY AUTOS
BODILY INJURY (Per aoddent)
$
HIRED NON -OWNED
AUTOS ONLY AUTOS ONLY
PROPERTY DAMAGE
Per accident
$
A
X UMBRELLALUlB
X
OCCUR
HFF0009972
7/19/2019 7/19/2020
EACH OCCURRENCE
$51000,000
AGGREGATE
$ 5,000,000
EXCESS LIAR
CMMS-MADE
DEC RETENTION $
$
D
E
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY YIN
OFFICEANYPRIMEMB R/PARTNER/EXECUTNE
EREXCLUDE09
NIA
D001224971
WC928528424284
7/19/2019 7/19/2020
7/19/2019 7/19/2020
X I PER OTH-
STATUTE ER
E.L. EACH ACCIDENT
$ 1,000,000
E.L. DISEASE- EA EMPLOYEE
$1,000,000
(Mandatory In
(Mandatory in NH)
H yes, describe under
DESCRIPTION OF OPERATIONS below
E.L. DISEASE - POLICY LIMIT
$ 1.000,000
C
Equipment Floater
45469291 EUC
7/19/2019 7/19/2020
Leased and Rented
$400.000
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space is required)
Certificate Holder is included as Additional Insured (except as respects coverage afforded by the Workers Compensation) and is granted a Waiver of
Subrogation as required by written contract, but only for liability arising out of the Operations of the Named Insured. This insurance certified herein will apply as
Primary and Non- Contributory as required by written contract. Umbrella is Follow Form.
City of Fort Collins
P.O. Box 580
Fort Collins CO 80526
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