HomeMy WebLinkAboutMD ROOFING LLC - INSURANCE CERTIFICATE (4)MDROOFI-01 BLONGCRIER
ACERTIFICATE OF LIABILITY INSURANCE DATE(M si27/202YYY)
2o20
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(les)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 certifiaate_does,not confer rights to the certificate holder in lieu of such endorsements .
PRODUCER N TACT Leiann Moss, CIC
CB Insurance, LLC Pl�19 HONE 477-4245 4245 FAX
(719) 228-1070 G M ao, Ext): `, ) (AIC, No
1 South Nevada Ave.; Suite 230 p . leiann.moss@centralbancorp.com
Colorado Springs, CO 80903
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INSURED
MD Roofing, LLC
6785 Horseshoe Road
Colorado Springs, CO 80923
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THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE
INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERr
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN
�ISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FORTHE POLICY PERIOD
OR CONDITION OF ANY CONTRACTOR 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.
INSR
TYPE OF INSURANCE
ADDL
SUBR
POLICY NUMBER
POLICY EFF
pp
POLICY EXP
_ LIMITS
A
X
COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE X OCCUR
VOGPOO2394
lonsrzols
10/26/2020
EACH OCCURRENCE
.$ 1,000,000
DAMAGE TO RENTED
acdcu
$ 50,006
MED.EXP (Any one erson
$ 5,000
PERSONAL B ADV. INJURY
.$ 1,000,000
GENT AGGREGATE LIMIT APPLIES PER:
POLICY 1XI jP& LOC
OTHER:
GENERAL AGGREGATE
.$ 2r000,000
PRODUCTS-CO MPIOP AG.G
.$ 2,000,000
$
AUTOMOBILE LIABILITY
ANY AUTO
AIUIgqTEEO��S ONLY AUTNOOSyUyL�EEDp
AUTOSONLY AUTOS ONLY
_
BINED
ED accident) SINGLE LIMIT
c
$
BODILY INJURY Perperson)
$
BODILY INJURY Per accident
$
PROPERTY AMAGE
Peraaident
$
UMBRELLA LIAB
EXCESS LIAB
OCCUR
CLAIMS -MADE
EACH OCCURRENCE
$
AGGREGATE
DIED RETENTION$
B
WORKERS COMPENSATION
AND EMPLOYERS'LIABILITY
ANY PROPRIIETgORIPARTNER/EXECUTIVE YIN
Mandatory In NHj EXCLUDED?
If yes, describe under
DESCRIPTION OF OPERATIONS below
N /'I`
21017$
6/1/2020
6/1(2021
X PER OTH-
STATUTE ER
E.L. EACH ACCIDENT
$ 1,000,000
E.L. DI$EABE - EA EMPLOYEE
$ 1'050'050
E.L. DISEASE - POLICY LIMIT
11000,000
$
.. ...
DESCRIPTION OF OPERATIONS /LOCATIONS /VEHICLES (ACORO 701, Additional
Remarks Schedule, may be attached N more space Is required)
City of Fort.Collins
424 W Mulberry St _
Fort Collins, CO 80521
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE
ACORD 25 (2016103) I 01088-2015 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD