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HomeMy WebLinkAbout133159 PAUL DAVIS RESTORATION OF FT COLLINS, CO - INSURANCE CERTIFICATEPAULDA-265 CHAF
ACOR ®� CERTIFICATE OF DATE (MM/DD/YYYY) LIABILITY INSURANCE 10/1712019
THIS CERTIFICATE IS ISSUED AS A MATTER OF IN ORMATION 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.hglder in lieu of such endorsements .
PRODUCER CNT CT -
The Loomis Company P&C Division PHONE Pax
850 N Park Road A/C, No, Eat): 610) 374-4040 c, Ne :(610) 376-1049
Wyomissing, PA 1.9610 M IL
INSURED INSURER B: Allstate Insurance Company
Wild West Restoration Inc. INSURER C: Arch Specialty Insurance Company 21199
DBA Paul Davis Restoration of Ft. Collins, CO
2636 Midpoint Drive, Unit A INSURER D: Pinnacol
Fort Collins, CO 80525 INSURERE: Berkley National Insurance Company 38911
INSURER F
f1nVF1OAGFQ r`CDTICIr-ATC YI IIUIDDD• DC\AQI/'11d IJI IMDFD-
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE (LISTED
BELOW HAVE BEEN. ISSUED TO THE INSURED NAMED A13OVE 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
ADOL
SUBR
pOLICY NUMBER
POLICY EFF
POLICY EXP
LIMITS
A
X
COMMERCIALGENERALLIABWTV
CLAIMS -MADE ❑X OCCUR
X
X
SP003660022019
10/17/2019
10/17/2020
EACH OCCURRENCE
1,000,000
$
DAMAGE TO RENTED
100,000
MED EXP (Any one.Person)
5,000
PERSONAL B ADV INJURY
$ 1,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
POLCY a met ❑X LOC
GENERALAGGREGATE -
$ 2,000,000
PRODUCTS-COMP/OP AGG
$ 2,000,000
OTHER: $2500 deductible
B
AUTOMOBILE
LIABILITY
COMBINED SINGLE LIMIT
IEa c'
1,000,000
$
X
BODILY INJURY Per person)$
ANY AUTO
X
648831084
10/17/2019
10/17/2020
OWNED SCHEDULED
AUTEONS ONLY AUTOS
BODILY INJURY Per accident
$
pert arE.cld ( AMP.GE
$
y�,�ED
AUTOS ONLY AUTOS ONLY
uninsured mot
1,000,000
C
X
UMBRELLA LAB
X
OCCUR
EACH OCCURRENCE
$ 2,000,000
AGGREGATE _
$ 2,000,006
EXCESSLAS
CLAIMS -MADE
12EMX1
94801
10/17/2019
10/17/2020
DED X_ .RETENTION$ 0
_
_
_
_
D
_
WORKERS COMPENSATION
AND EMPLDYER5 LABILITY Y I N
ANY PROPRIETOR/PARTNER/EXECUTIVE W
OFFICERIMEMBER EXCLUDED?
(Mandatory In )
If yes, describe.under. _.
DESCRIPTION OF OPERATIONS below
N/A
4213078
-
10/01/2019
10/01/2020
y( PER OTH-
LITE ER
E.L. EACH ACCIDENT
1;000,000
$
E.L..DISEASE -EA EMPLOYE
11000,000
$
E.L. DISEASE- POLICY LIMIT
1,000,006
A
Pollution
SPG0366 022019
10/17/2019
10/17/2020
$1M/$21W$5K ded
E
Bailees
MNP 102I1 155 - 50
10/17/2019
10/17/2020
250,000
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD101, Additional
If required by written contract, the Certificate Holder is an Additional
Products & Completed Operations and subject to the terms, condltions,and
Remarks Schedule, ma�r be attached If more. space Is required)
Insured on the General Liability policy, on a primary & non-contributory basis, including
exclusions of the policy.
Blanket waiver of subrogation applies to the general liability
Blanket Loss Payee applies for contractors' equipment coverage
SEE ATTACHED ACORD 101
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
City Of Ft. Collins & Poudre Fire Authority THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
tY ty ACCORDANCE WITH THE POLICY PROVISIONS.
PO Box 580
Fort Collins, CO 80522
AUTHOROED REPRESENTATIVE
James. R. Loomis
ACORD 25 (2016103) ©1988-2015 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD