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HomeMy WebLinkAboutSAFEBUILT HOLDING COMPANY - INSURANCE CERTIFICATE,AcoR" CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 9/25/2019 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 RBN Insurance Services 303 E Wacker Dr Ste 650 Chicago IL 60601 INSURED SAFELLC-01 INSURER B : Hartford Casualty Insurance Co 29424 SAFEbuiR Holding Company SAFEbuilt, LLC (See Attached) INSURERC: Navigators Insurance Company 42307 3755 Precision Drive, Ste 140 wsURERD: Twin City Fire Insurance Co. 29459 Loveland CO 80538 INSURER E : Great American E&S Ins. Co. 37532 COVERAGES CERTIFICATE NUMBER: 1455702886 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. ILTRR TYPE OF INSURANCE POLICY NUMBER MM/D Y EFF M� EXP LIMITS A X COMMERCIALGENERALUABILITY 83UENZV3951 10/3/2019 10/3/2020 EACH OCCURRENCE $1,000,000 CLAIMS -MADE F OCCUR PREMISES Ea oxunenca $300,000 $10,000 MED EXP (Any one person) $1,000.000 PERSONAL a ADV INJURY GEN'L AGGREGATE LIMIT APPLIES PER: $2,000,000 GENERAL AGGREGATE $2,000,000 X LOC POLICY ❑ JJEECTT PRODUCTS-COMP/OP AGG $ OTHER: E AUTOMOBILE LIABILITY 83UENPY9100 10/=019 10/3/2020 COMBINED SINGLE LIMIT Ea awdent $1.000,000 BODILY INJURY (Par pawn) $ X ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS X HIRED X NON -OWNED AUTOS ONLY AUTOS ONLY BODILY INJURY (Par acdden0 S PROPERTY DAMAGE Per accident $ $ C UMBRELLA LUIB X OCCUR CH19EXC8856001V 10/312019 10/3/2020 EACH OCCURRENCE $10,000,000 X AGGREGATE $10,000,000 EXCESS LIAB CLAIMS -MADE DED I X 1 RETENTION$ r $ I I o WORKERS COMPENSATION AND EMPLOYERS' LIABILFTY YIN ANYPROPRIETOR/PARTNER/EXECUTIVE 83WECE0623 5/12=19 5/1212020 X PER OT STATUTE ERA E.L. EACH ACCIDENT $1,000,000 OFFICERIMEMBEREXCLUDED? NIP` (Mandatory In NH) E.L. DISEASE- EA EMPLOYEE $1,000,000 E.L. DISEASE - POLICY LIMIT $ 1.000,000 under If yes, descirreeDESCRIPTION DOPERATIONS below L Professional Liability TER285-99-95 10/3/2019 10/3/2020 Each Claim/Aggmgate 9,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101. Additional Remarks Schedule, may be attached if mom space is required) City of Fort Collins is an Additional Insured as respects General Liability as required by a written contract or written agreement. CERTIFICATE HOLDER CANCELLATION 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. City Hall West AUTHORIZED REPRESENTATIVE -80&+aPorte Avenue Fort Collins CO 80521 t ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD