HomeMy WebLinkAboutLEFEVER BUILDING SYSTEMS - INSURANCE CERTIFICATEA6OZP DATE MM/DD/YYYY)
��. CERTIFIC�1 E OF LIABILITY INSURANCE 5/29rz02Q
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(les) must have ADDITIONAL,INSURED provisions or be endorsed.
If SUBROGATION IS WAIVED, subject to the terms an conditions of. the policy, certain policies may require an endorsement. A statement on
this certificate does not confer rights to the certificate h Ider in lieu of such, endorsemen s ._ .-.
PRODUCER I NUAMR Sabrina Rahe
Commercial Risk Solutions PHONE
6600 E Hampden Ave Ste 200 (AMtie , Erile 303-996-7834
Denver CO 80224 Aoo Ess: srahe crsdenv
Westfield Insurai
Lefever Building Systems
V 5 Inc. & V Five Inc. dba
7230 Gilpin Way, Unit 160
Denver CO 80229
THIS IS: TO CERTIFY THAT THE_ POLICIES OF INSURANCE LISTED
INDICATED. NOTWITHSTANDNG ANY REQUIREMENT; TERM
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE
EXCLUSIONS AND CONDITIONS OF SUCH POLICfES._UMrrSSHOWN
BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE„POLICY-PERIOD
OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
MAY HAVE BEEN REDUCED BY PAID CLAIMS.
IL gR
TR
-
TYPE OFINSURANCE
L
UBR
�.P000Y.NUMBER
POLICY EFF
MAVD6/YY
MM�DDIYY
POLICY EXPtPERSONAL
LIMITS; -
A
X
COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE � OCCUR
Stop dap ND
TRA6042325
5/31/2020
513112021.
RENCE
$1.000,000
�mrence
$500,000
X
one arson)
$10,000
ADV INJURY
$1.000.000
GEN'L AGGREGATE LIMITAPPLIES PER:
POLICYa PRO- LOC
OTHER:
REGATE
$2,000,000
PRODUCTS -COMPIOP AGO
$2,000,006
Sto GOD
$1.000,000
A
AUTCIMOBB.ELIABILRY
X ANY ALTO
OWNED SCHEDULED
AUTOS ONLY AUTOS
X HIRED X, NON -OWNED
- .AUTOS ONLY AUTOS ONLY
TRA6042325
5/312020
5/31/2021
Z OMBINEDSINGLELIMIT
aaecidant
$1,000.000
BODILY INJURY (Per person)
$
BODILY INJURY (Per accident)
S
PROPERTY DAMAGE
$
$
A
X
UMBRELLA LIAR X OCCUR
EXCESS LIAB I CLAIMS -MADE
TRA6042325
5131/2020
5/312021
EACH OCCURRENCE
$10,000.000
.AGGREGATE
$10,000,000
DED I X I RETENTIONS
- — --
$ -
B
WORICERS COMPENSATION
AND EMPLOYERS' LIABILITY Y / N
ANYPROPRIETOR/PARTNER/EXECUTIVE -1
OFFICERtMEMSER EXCLUDED?
(Mandatory In IDQ-
II yes. describe under
DESCRIPTION OF OPERATIONS below-
N / A
4057998
71112020
P1/2021
X I g7ATOTE R..
_ _
E.L. EACH ACCIDENT
$1,000,000
E.L. DISEASE - EA EMPLOYEE
$1.060,600
EL. DISEASE • POLICY. LIMIT
$1000.000.
A
ILease/Rented Equip -TRA6042325
Scheduled Equip see
below description
5131/2NO
5/312021
UmB:
Ded:
525;000 -
2.500
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD i01, Additional
All policy terms, conditions and exclusions apply.
Remarks Schedule,. may be attached if more space la requtred)
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
City of Fort Collins Community Planning & E
vironment
P. O.. BOX 586
Fort Collins CO 80522
AUTHORIZED REPRESENTATIVE
%w IDOO'LYA 7 ANV RY V VI'IrVnN r rvn.. iw, nynwr wool vow.
ACORD 25 (2016103) The.ACORD nBrine and logo are registered marks of ACORD
2' or2 7651