HomeMy WebLinkAboutBIG HORN ROOFING INC - INSURANCE CERTIFICATE (2)BIGHORN-37
Ali CERTIFICATE OF LIABILITY INSURANCE DATE 8/15/2019
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
Wyoming Financial Insurance
400 E 1 st St, Ste 105
Casper, WY 82601
INSURED
Big Horn Roofing Inc.
605 S Adams
Laramie, WY 82070
Patti
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233-8302
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V 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
TYPE OF INSURANCE
IADDL
NSO
SUBWVDJ
POLICY NUMBER
POLICY EFF
POLICY EXP
LIMITS
A
X
COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE [X OCCUR
X
X
ACPGL03028312104
9/1/2019
9/1/2020
EACH OCCURRENCE
$ 1,000,000
DAMAGE TO RENTED
PREMISES fEa occurrence)VIED
$ 100,000
EXP (Any one rson
$ 10,000
PERSONAL &ADV INJURY
$ 1,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
POLICY j LOC
OTHER:
GENERAL AGGREGATE
$ 2,000,000
PRODUCTS - COMP/OP AGG
2,000,000
A
AUTOMOBILE LIABILITY
X ANY AUTO
OAMED SCHEDULED
AUTO S ONLY ALIT O�SWNE
AUTOS ONLY AUTOS ONL�
X
X
CPBAL3028312104
9/1/2019
9/1/2020
COMBINED SINGLE LIMIT
1�000�QQO
$
BODILY INJURY Per son
$
BODILY INJURY Per accident
$
PPere¢IdeM AMAGE
A
X
UMBRELLALJAB
EXCESS LIAB
X
OCCUR
CLAIMS -MADE
X
X
CPCAA3028312104
9/1/2019
9/1/2020
EACH OCCURRENCE
$ 5,000,000
AGGREGATE
$ 5,000,000
DED I RETENTION $
B
WORKERS COMPENSATION
AND EMPLOYERS'LIABILITY YIN
ANY PROPRIETOR/PARTNER/EXECUTIVE ❑
Wp�'F'1 ER/M�MBER EXCLUDED?
(Mandatory In NH)
If yes, describe under
DESCRIPTION OF OPERATIONS below
N / A
CP3028312104 STOP GAP
9/1/2019 9/1/2020
PER OTH-
E.L. EACH ACCIDENT
1,000,000
E.L. DISEASE - EA EMPLOYE
1,000,000
$
E.L. DISEASE -POLICY LIMIT
1'000,006
$
A
C
Leased & Rented Equi
Pollution Liability
CPCIM3028312104
G46803978003
9/1/2019
9/1/2019
9/1/2020
9/1/2020
Each Condition
200,000
2,000,000
DESCRIPTION QF OPERATIONS 1 LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached H more apace Is required)
City of Fort Collins
PO Box 580
Fort Collins, CO 80522
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�i htL atllex—
ACORD 25 (2016103) U 19S8-ZU15 ACUHU UUKF UKA I IUN. AN rlgnrs reservea.
The ACORD name and logo are registered marks of ACORD