HomeMy WebLinkAbout266869 ABS ASSOCIATED BUILDING SPECIALISTS INC - INSURANCE CERTIFICATEACORD., CERTIFICATE OF' LIABILITY INSURANCE DA/29/DD/YVVY)
� 5/I/z_n21 4/29/2020
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 poiicy(liis) 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).
8110 E Union Avenue
Suite 700
Denver CO 80237
(303)414-6000
INSURED Associated Building Specialties, Inc.
1352712 3764Imperial Street
Frederick, CO 80516
Casually Co of America
rnVFDAnFC rCDTiCtr`ATC au ilucoo.. 1 AAOG'On4 13e..rere,.r w doers-. V V V V V V v
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCELISTED
BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FORTHE POLICY PERIOD
RM INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TE
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.
INS
TYPE OF INSURANCE
A
SUBR
N
CPA3242073-20
POLICY NUMBER
POLICY EFF..
5/1/2020
LICY EXP
POLICY
5/l/2021
- LIMITS
EACH OCCURRENCE
1000000'
A
X
COMMERCIAL GENERAL LIABILITY
Y
CLAIMS-MADEFRI OCCUR
DAMAGE TO RENTED
PREMISES Ea. occurrence
3OO OOO
MED EXP (Any oneperson)
5,000
PERSONAL & ADV INJURY
$ 1000 000
GENT AGGREGATE LIMIT APPLIES PER:
GENERAL AGGREGATE
$ 2,000,000
POLICY E� LOC
PRODUCTS :.COMP/ORAGG
$.2 OOO 000
OTHER_ _
-
$ - -
A
AUTOMOBILE'
LIABILITY
Y
N
CPA3242073-20
5/I/2020
5/1/2021
C MBINED SINGLE LIMIT
Ea accident
$ 1000 000
BODILY INJURY (Per person)
$ XxxXxxx
ANY AUTO
Ix
AUTOS ONLY AUTOSULED
BODILYINJURY (Peraaident
$ xxxxxxX
HIRED - NON -OWNED
AUTOS ONLY x AUTOS ONLY
PROPERTY DAMAGE
Per accident
---
$ xxxxxxx.
$xxxxxxx.
q
X
UMBRELLALUIB
I V
IOCCUR
N
N
CPA3242073-20
5/1/2020
5/I/2021
EACH OCCURRENCE
$ 10,000,600
H
EXCESS LIAR
CLAIMS -MADE
ZUP-21PI
0I80-20-NF
4,/1/2020
5/I/2021
AGGREGATE
-
$ 10 000 000-
DED RETENTION$
$ XXXXXXX
_
C
WORKERS COMPENSATION
AND EMPLOYERS'LUIBILITY Y/N
N
4223411
5/1/2620
5/I/2021
_
X STATUTE GER
E.L. EACH ACCIDENT .
$ 1000 Ont)0
ANY PROPRIETORMARTNERIEXECUTIVE
OFFICER/MEMBER EXCLUDED? N❑
N / A
(Mandatory in NH)
11 yes. describe under
E.L. DISEASE -EA. EMPLOYEE
1000 L/00
EL DISEASE -POLICY LIMIT1111
1000.000
DESCRIPTION OF OPERATIONS below
A
Inventory /Stock/ BPP of
N
N
CPA324207340
5/1/2020
5/I/202I
$1.308.700 Limit
Others - Imperial Location
-
DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional
Remarks Schedule, may beattached if more space is required)
CITY OF FORT COLLINS IS ADDITIONAL INSURED ON GENERAL,
AND AUTO COVERAGE, IF REQUIRED BY WRITTEN CONTRACT AND
SUBJF.Cr'i'O THE TERMS AND CONDITIONS OF THE POCKY.
I�G�TI Cl/�ATr L,�l Ml m i
_
14095308
CITY OF FORT COLLINS
PO BOX 580
FORT COLLINS CO 80524
P%LLNDIIIIICII
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE- WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
The ACORD name and logo are registered marks of ACORD
Attachment Code: D577788 Master ID: 1352712, Certificate ID: 14095308
Associated Building Specialties Inc
3764 Imperial St
Frederick, CO 80516-9445
ENDORSEMENT: Blanket Waiver of
7501 E. Lowry Blvd.
Denver, CO 80230-7006
303.361.4000 / 800.873.7242
NCCI #: WC000313B
Policy #: 4223411
Lockton Companies, LLC-Denver
8110 E. Union Ave.
Suite 700
Denver, CO 80237-2984
(303) 414-6000
We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not
enforce our right against the person or organization named in the Schedule. This agreement, applies only to the
extent that you perform work under a written contract that requires you to obtain this agreement -from us.
This agreement shall not operate directly
To any person or organization H
and with the insured, which is in
Effective Date:May 1, 2020
Pinnacol Assurance has issued this
indirectly to benefit anyone not named in the Schedule.
SCHEDULE
agreed to under a written contract or agreement, as defined above
!ct and executed prior to any loss.
Expires on: May 1„ 2021
%.ment May 7, 2020
Page 1 of 1 P
7501 E. Lowry Blvd Denver, CO 80230-7006
- Underwriter 05/07/2020 11:26:49 4223411 55963779 359-B
Attachment Code : D577858 Master ID: 1352712, Certificate ID: 14095308
COMMERCIAL GENERAL LIABILITY
CL CG 04 92 30 18
THIS ENDORSEMENT
GENERAL LIABI
This endorsement modifies insurance
COMMERCIAL GENERAL LIABILITY
THE POLICY. PLEASE READ IT CAREFULLY.
ULTRA PLUS ENDORSEMENT
under the following:
E PART
SUMMARY OF COVERAGE EXTENSIONS
Provision
Name
Of Coverage Extension
Included or Limit of
Insurance
A.
Miscellaneous Additional
Insureds
Included
B.
Expected Or Intended Injury
Or Damage
Included
C.
Knowledge Of Occurrence
Included
D.
Legal Liability — Damagel
Ex losion Smoke Or Leakage
To Premises Rented To You (Fire, Lightning,
From Automatic Fire Protective Systems)
$300,000
E.
Medical Payments
I
See Declarations
F.
Mobile Equipment Redefined
Included
G.
Newly Formed Or Acquired
Company -And -Extended
Organization, Partnership Or -Limited Liability
Period.Of Coverage
Included
H.
Who Is An Insured — Amendment
Included
I
Non -Owned Watercraft Increased
feet
to maximum length of less than 51
Included
JW
Supplementary Payments'—
1. Bail Bonds
2. Loss Of Earnings
Increased Limits
-
$ 3,000
$ 1,000
K.
Unintentional Omission Or
Unintentional Error In Disclosure
Included
L.
Waiver Of Transfer Of Rights
Of Recovery Against Others
Included
M.
Liberalization Clause
-Included
N.
Incidental Medical Malpractice
Included
The above is a summary only. Please
extensions provided.
The provisions of the Commercial C
Coverage Part apply except as other
this endorsement. This endorsement
such Coverage Part is included in this
A. MISCELLANEOUS
1. Section II Who Is An
amended to include as an insun
or organization (referred to as
insured below) described in
A.1.c.(1) through A.1.c.(9)
you and such person or orga
agreed
CL CG 04 92 10 18 Includes
the specific provisions that follow for complete information on the
I Liability
in writing in a contract or agreement that
ovided in
such person or organization be added as an
�s only if
additional insured on your policy, provided
that:
DNAL
a. The written contract or written agreement
REDS
is.
(1) Currently in effect or becoming
anyperson eis effective during the term of this policy;
any and
i additional
Paragraphs (2) Fully executed by you and the
elow when additional insured prior to the "bodily
:ation have
hted material of Insurance Services Office, Inc., Page 1 of 8
with its permission
Attachment Code : D577865 Master ID: 1352712, Cl rtificate ID: 14095308 COMMERCIAL AUTO
CL CA 20 93 03 19
THIS ENDORSEMENT
BUSINESS AUTO
This endorsement modifies insurance
BUSINESS AUTO COVERAGE FORM
THE POLICY. PLEASE READ IT CAREFULLY.
HANCEMENT PLATINUM PLUS
under the following:
OF COVERAGE EXTENSIONS
Paragraph
No.
Name Of Extension
Limit or
Included
A
Additional Insured by Contract Or Agreement Including Primary and
Noncontributory Otherlinsurance Condition
Included
B.
Airbags - Extended Coverage
Included
C.
Telematics & GPS Equipment Coverage
$2,500
D.
Electronic Equipment—Ilncreased Coverage
$2,500
E.
Auto Loan/Lease Gap Coverage
Unlimited
F.
Autos Rented by Employees
Included
G.
Bail Bonds - Extended Coverage
$5,000
1{
Broad Form Named Insured Including Newly Acquired or Formed
Organizations
Included
I.
Custom Signs & Decorations
Included
J.
Employees as Insureds
Included
K.
Family Emergency Travel Reimbursement
$2,500
L.
Fellow Employee Coverage
Included
M
e ge
Fire Extinguisher Recharg
included
N.
Glass Repair— No Deductible
Included
O
Hired Auto Physical Damage and Increased Loss of Use
Expenses Loss of use (Per Day /Maximum)
$100,000
$560 / $3,500
P
Hybrid Auto Payment Coverage (per auto / per loss)
$200/ $5,000
Q.
Knowledge Of An Accident, Claim, Suit Or Loss
included
R.
-
Limited Worldwide Hired & Non Owned Auto Coverage
---- - - - -.
Included
-
S.
Loss Of Earnings - Extended Coverage
$1,000
T.
New Vehicle Replacement Cost
Included
U.
r-
Rental Reimbursement Coverage
Maximum Rental Expenses Per Day
$75
Maximum Rental Expenses Because Of Loss To Any One Covered
"Auto"
$3,375
Maximum Rental Expenses Because Of Loss To All Covered "Autos"
In Any One Policy Pei-od
$15,000
CL CA 20 93 0319 Includes copyrighted material of Insurance Services
Offices, Inc. with its permission
Page 1 of 8
Attachment Code: D577865 Master ID:
1352712, Certificate ID: 14695308
V.
Personal Effects Coverage
$500
W.
Resultant Mental Anguish
Included
X.
Towing And Labor Coverage
Private Passenger
Other than Private
Extension
Type
(Passenger Type
$2600
$2
Y.
Transportation Expense.
- Coverage Extension ( Per Day I Maximum)
$75 I $2,500
Z.
Unintentional Failure TolDisclose
Hazards
Included
AA.
Waiver Of Collision Deductible
= Attached Autos
Included
BB.
Waiver Of Subrogation By
Contract Or Agreement
Included
A. ADDITIONAL INSURED BY COP
AGREEMENT INCLUDING PRII
NONCONTRIBUTORY OTHER
CONDITION
The following is added to Par
Who Is An Insured of Section II
Autos Liability Coverage:
When you have agreed in a writ
or agreement to include a
organization as an additional ii
person or organization is inch
'insured" subject to the following:
1. Such person or organization is
insured only to the extent Sul
organization is liable for "boc
"property damage" because of
of an "insured" under Paragrs
under Paragraph A.1. Who Is �
Section 11 — Covered At
Coverage, caused by an "a
resulting from the ownership,
or use of a covered "auto".
OR 5. The following changes are made to
AND Paragraph 5. Other Insura-nce of B.
NCE General Conditions under Section IV
—Business Auto Conditions:
A.I. a. The following is added to Paragraph
ered 5.a.:
contract
son or
%d, such
as an
additional
person or
injury" or
s a. or
Insured
ntenance
2. The written contract or lagreement
described above must have been executed
prior to the "accident" that ¢aused the
"bodily injury" or "property damage" and
be in effect at the time of such "accident".
3. The insurance afforded to any such
additional insured does not apply to any
"accident" beyond the period of time
required by the written contract or
agreement described above.
4. The most we will pay on behalf of such
additional insured(s) is the lesser of -
a. The Limits of Insurance specified in the
written contract or agreeme t described
above; or
b. The Limits of Insurance
Declarations.
This provision shall not incr(
of Insurance shown in the. D
this policy or coverage part.
in the
Limit
ns in
If required by the written contract or
agreement described above, the
insurance afforded to the additional
insured under this provision will be
primary to, and will not seek contribution
from, the additional insured's own
insurance.
b. Paragraph 5.c. is deleted in its entirety.
6. Paragraph A.1.c. under Section II -Covered
Autos Liability Coverage is deleted in its
entirety.
7. The definition of "insured contract" under
Section V — Definitions is amended to
add the following-.
An "insured contract" does not include
that part of any contract or agreement:
That pertains to the ownership,
maintenance or use of an "auto" and
which indemnifies a person or organization
for other than the vicarious liability of such
person or organization for "bodily injury" or
"property damage" caused by your operation
or use of a covered "auto".
However, a person or organization is an
additional "insured" under this provision only
to the extent such person or organization is
not named as an "insured" by separate
endorsement to this policy.
B. AIRBAGS- EXTENDED COVERAGE
Section III — Physical Damage Coverage,
Paragraph B.3.a. does not apply to the
unintended discharge of an airbag. Coverage
is excess over any other collectible insurance
or warranty specifically designed to provide
coverage.