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HomeMy WebLinkAbout330878 SIMPSON & SIMPSON SALES & SERVICE INC - INSURANCE CERTIFICATE (5)ACORO� CERTIFICATE OF LIABILITY INSURANCE �i DATE(MMIDD/YYYY) 8/19/2019 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 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. #101 Greenwood Village CO 80111 CONTACT NAME: PHONE FAX (Arc, No, Ext); 303-867-2055 AK No: 303-867-2074 ADDRESS: o2@olsonandolson.com INSURE S AFFORDING COVERAGE NAIC It INSURERA: Westfield Insurance Company 24112 INSURED 8 Simpson Sales 8 Service, Inc. SIMPS-1 SimpsonPO BOX 524 INSURERS: Pinnacol Assurance 41190 INSURERC: INSURER D: Broomfield CO 80038 INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: 1475529134 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 A L UBR - POLICY NUMBER POLICY EFF MMIDDIYYYY POLICY EXP MMIDDIYYYY LIMITS A GENERAL LIABILITY CWP5452191 9/1/2019 SM/2020 EACH OCCURRENCE $2,000,000 COMMERCULL GENERAL LIABILITY OAMA0E_TO RENTED PREMISES Ea occurrence $ 300.000 CLAIMS -MADE a OCCUR MED EXP (Any one person) $ 5,000 PERSONAL $ ADV INJURY $ 2,OW.000 GENERAL AGGREGATE $4,000.000 PRODUCTS-COMP/OP AGG. $4,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY ^ PRO- LOG $ A AUTOMOBILE LIABILITY CWP5452191 9112019 9/12020 COMBINED SINGLE LIMIT Ea accident BODILY INJURY (Per person) $ ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS Ix BODILY INJURY (Per accident) $ PROP(PerPEEROT DAMAGE S HIRED AUTOS X AONOSWNED III A X UMBRELLA LAB X OCCUR CWP5452191 9112019 9112020 EACH OCCURRENCE $ZD00,M0 AGGREGATE $ EXCESS LAB CLAIMS -MADE DIED X I RETENTIONSO $ B WORKERS COMPENSATION 4095690 9/12019 SM2020 X I WCSTATU- I I OTH- LIMITS ER ANDEMPLOYERS'LIABILITY YIN ANY OFFICER MEM ER/EXCLUDED? ECUTIVE NIAPARTNER/EX E.L. EACH ACCIDENT $1,000,000 E.L. DISEASE - EA EMPLOYE $1,000,000 (Mandatory in NH) If es, describe under DESCRIPTION OF OPERATIONS belo.r E.L DISEASE - POLICY LIMIT S 1,000,000 I DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, 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. Contract work. �ny.�atrLz�syai� •� �.� City of Fort Collins 300 LaPorte Ave Ft 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 ';�441V_&C'�m © 1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD