HomeMy WebLinkAboutMICHAEL NOELLER CONTRACTING LLC - INSURANCE CERTIFICATE (2)Ali DF CERTIFICATE OF LIABILITY INSURANCE "q'`IMW"WTTTI
10/29/2019
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 poficy(ies) must he endorsed. If SUBROGATION IS WAIVED, subject to
the terms and conditions of the poli
cy, cy, certain policies may require an endorsement A statement on this certificate does not eorde► rights to the
The Reilly Company LLC PHONE (913) 682-1234 Not (913)6e2-e136
608 Delaware St. ADDRESS:janice.aaron@reillyinsurance.com
P-O. Box 9 INSURE S AFFORDING COVERAGE- MAIC 0
Leavenworth SS 66048-0009 NSURERA:Nationwide_ 00035
INSURED INSURERS: _ _
Michael Noeller. Contract'„ LLC .NSURERC.:
PO Box 602 INfIIRFR n,
Liberty MD 64069 1 1 INSURERF: I )
P.AVFRAr:FS CFRTIFICATF NIIMRFR•Maater 19 RFVISICIN NLIMRFR
THIS IS TO CER IFY THATTHE POLICIES OF INSURANCE LISTED
BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. N0TIMTHSTANDINGANY REQUIREMENT TERM ORICONDITION
OFANY CONTRACTOR OTHER bOCUMENT WITH RESPECTTO WHICH"THIS
CERTIFICATE MAYBE 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
ADOL
-
SUSR-.
__ -
POLICY NUMBER
P01kCY.EFF
MMID
POLICY EXP---
MMIO
-
LIMITS-
X
COMMERCIAL GENERAL LIABILITY
._...____
EACH OCCURRENCE
-t_
. 1,000,000
SDAMAGE
A
CLAIMS -MADE X OCCUR
TO RENTED
PREMISES Ea ocarterxe1
$ 100, 000
MED EXP(Any one person)
$ 10,000
ACP 3047352616
10/31/2019
10/31/2020
PERSONAL A ADV INJURY
S 1,000,660
GENLAGGREGATE UMITAPPLIES PER:
GENERALAGGREGATE
$ 2.,000,000
POLICY � JECT- LOC
PRODUCTS-COMP/OPAGG
S 2.,000,000
$
OTHER:
AUTOrrOBILE LIABILITY
BIKED SINGLE LIMIT
Ea accident -
$ 1.,000.,000
BODILY INJURY (Per person)
S
A
JX ANY AUTO
ALL OWNED SCHEDULEDAUTOS
AUTOSNON-OWNED
ACP BAIL
047352616
10/31/2019
10/31/2020
BODILY INJURY (Par accident)
$
PROPERTY DAMAGEHIRED
Per accident)$
AUTOS X AUTOS
Undertnsumd nwWst combined sir
$ 1,000,660
X_
UMBRELLA LIAR
X
OCCUR
EACH OCCURRENCE
$ 5,000,600
AGGREGATE
It 5,000,000
A
EXCESS LUIB
CLAIMS -MADE
DED I I RETENTION S
S
ACP CAA
047352616
10/31/2019
10/31/2020
A
WORKERS COMPENSATION
- - - - -- - - - -
AND EMPLOYERS' LIABILITY Y / N
ANY PROPRIETORIPARTNER/EXECUTIVE
OFFICER/MEMBER EXCLUDED?
(Mandatory In NH)
NIA
ACP WC 3047352616
10/31/2019
10/31/2020
X ER TH-
STAT TE ER
E.L. EACH ACCIDENT
S 500,000
E.L. DISEASE -EA EMPLOYEE
$ 500,000
If yes, describe under
DESCRIPTION OF OPERATIONS below
E.L. DISEASE - POLICY LIMIT
S 500,000
A
Leased/Rented Egnipmeat
ACP 3047952616
10/31/2019
30/31/2020
Unsl S400,000 Dad $1,000
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additlonal
Remarks Schedule, my be athched S more apace M required)
VGR I Irl VMz Q rlw W QR IVI91e V GGL/1I , V n
(970)224-6134 kEharp@fcgov.com
City of Fort Collins
PO Box 580
Fort Collins; CO 80522-0580
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
Nit EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE'WRTH THE. POLICY PROVISIONS,
s Bray/JANICE
ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD
INS025-(2a14D1)