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HomeMy WebLinkAboutMARSHALL BROTHERS CONSTRUCTION LLC - INSURANCE CERTIFICATEACORO CERTIFICATE OF LIABILITY INSURANCE �� DATE(MwDDrMy) 09l01/2019 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 endorsements . PRODUCER Stailey Insurance Corporation 2084 S. Milwaukee Street Denver CO 80210. CONTACT Bonnie Dyson PHONE FAx . (303)759-2796 .(303)759-2960 E MAtI bonnie)@staileycorp.com N R R AFFORDING COVERAGE NAIC0 INSURER A, Mesa Underwriters Specialty Insurance 36838 INSURED Marshall Brothers Construction, LLC dba: NSA .PinnacolAssurance 1190 G2 Roofing and Construction INSURER C: 6920 S. Jordan Road, Suite H INSURER D Centennial CO 80112- COVERAGES CERTIFICATE NUMBER: 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 TYPE OF INSURANCE ADDL SUER POLICY EFF POLICY EXP LIMITS A X COMMERCIAL GENERAL LIABILITY X X CLAIMS-MADEOCCUR GEMLAGGREGATE LIMIT APPLIES PER: POLICY NPRO- JECT LOC - OTHER MP00050033001668 09/27/2019 09/27/2020 EACH OCCURRENCE S 1,000,000 DAMAGE TO RENTED ¢ado. 100,000 MED EXP (Any one arson 5.000 PERSONAL B ADV INJURY S 1,000,000 GENERALAGGREGATE PRODUCTS -COMP/OPAGG S 2.000,000 1 3 2,000,000 S AUTOMOBILE LIABILITY ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS NON -OWNED HIRED AUTOS AUTOS COMBINED SINGLE UNIT E. nW $ BODILY INJURY (Per person) S BODILY INJURY (Per accident) S PROPERTY DAMAGE S S A X UMBRELLA Liao EXCESS LIAR X OCCUR CLAIMSWADE BE080751085 i09/27/2019 9/27/2020 EACH OCCURRENCE 1,000,000 AGGREGATE $ 1,000,000 QED RETENTION S B WORKERS COMPENSATION AND EMPLOYERS'LIABWTY YIN ANY PROPRIETORIPARTNERIEXECUTrVE r 'M/A OFFICERIMEMBER EXCLUDED7 U (Mandatory In NH) If yea, describe under DESCRIPTIONN X 4195907 10/01/2019 10/01/2020 X I PER OTH- EL EACH ACCIDENT S SOO,000 E.L DISEASE _EA EMPLOYEE E.L DISEASE -POLICY LIMIT S 500,000 500.000 T7 DESCRIPTION OF OPERATIONS I LOCATIONS 1 VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached 11 more apace Is required) SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Fort Collins ACCORDANCE WITH THE POLICY PROVISIONS. P.O. Box 580 Fort Collins CO 80522- AUTHORIZED REPRESENTATIVE ^ O nA /� —LK3 drv...J cam.• �` ___` © 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD