HomeMy WebLinkAbout680291 AMERICAN CONTRACTING LLC - INSURANCE CERTIFICATEACORN® CERTIFICATE OF LIABILITY INSURANCE
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04/13/2020
THIS CERTIFICATEIS 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 *HE CERTIFICATE HOLDER.
IMPORTANT: N the "certificate holder is an -ADDITIONAL INSURED, the policy(ies)-must have ADDIMONACINSURED provisions or be "endorsed.
H 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).
PRODUCER - _ _ _ -
NCONTACT AME: _ _ Kairen GBOrg6_ CISR
Flood and Peterson
PHONE (720)977=6026 A� Nc: (970)330-1867
ADDRESS: s: KGeorge@FloodPeterson.com
PO Box 578
INSURER AFFORDING COVERAGE
NAICIf
Greeley CO 80632
INSURER A: Westfield Insurance
INSURED
INSURER 9: Pinnacol ASSu2n-ce
American Contracting, LLC
INSURERC:
3131 S. College, Suite B
INSURER.D:.
INSURER EFort
[INSURER
Collins CO 80625
F.:
COVERAGES CERTIFICATE NUMBER:. CANCELLED REVISION NUMBER:.
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE 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.
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFF
MWODN
POLICY EXP
MWDDNY
OMITS
COMMERCIALGENERALUABILITY
EACH OCCURRENCE
$. 1,000,000
rA
CLAIMS -MADE ® OCCUR
PREMISES Edcccdirrence
$ 500,000
MED EXP we ,son
$ 5,00D
PERSONAL BAD4114JURY
$. 1,000,000
Y
TRA7902690 - CANCELLED
10/01/2019
04/15/2020
GEN'L AGGREGATE LIMIT APPLIES PER:
GENERALAGGREGATE
5. 2,0W'000
POLICY ® PRO-
JECT 7 LOC
PRODUCTS - COMP/OPAGG
$ 2,000,000
Stop Gap Wyoming
$ 1,000,000
OTHER:
AUTOMOBILE
LIABILITY
COMBINED SINGLE LIMIT
Ea accident
s 1,000,000
BODILY INJURY (Per person)
$
ANY AUTO
A
OWNED SCHEDULED
y
TRA7902690-CANCELLED
10/01/2019
04/15/2020
BODILY INJURY (Per accident)
$
AUTOS ONLY AUTOS -
PROPERTY DAMAGE
$ - --
HIRED NON -OWNED
AUTOS ONLY AUTOS ONLY
Per accWanI
If
UMBRELLA LIAR
OCCUR
EACH OCCURRENCE
$2,000,000
AGGREGATE
$ 2,000,000
A
EXCESS LIAR
CLAIMS -MADE
TRA7902690 - CANCELLED
10/01/2019
04/15/2020
DED I . ,RETENTION.$. 0
1
1
1$
WORKERS COMPENSATION -
_ -
- - -_
-- -
PER'
OTH-
ANDEMPLOYERS'LIABILITY Y/N
STATUTE.
ER-.
-
E.L. EACH ACCIDENT
$ 1,0001000
B
ANY PROPRIETORMARTNERIEXECUTNE
El
N/A
-4177579
02/01/2020
02/01/2020
E.L. DISEASE - EA EMPLOYEE
$ 1,000,00o
OFFICER/MEMBEREXCLUDED? )
(Mandatory in NH)
If Yes. dasodEo under
DESCRIPTION OF OPERATIONS below.
-
E.L. DISEASE - POLICY LIMIT
$ 1,000,000
Leased/Rented Equipment
A
TRA7902690 - CANCELLED
10/01/2019
04/15/2020
$25,000 Limit
$1,000 Ded.
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additimgl Remarks Schedule, may be attached If more space is required)
Re: Fire Protection and Alarm System Expansion
Certificate holder is included as Additional Insured for General Liability and Automobile Liability as required by written contract with respects to liability arising
out of work performed by the named insured.
CFRTIFICATF Nnt nm CANCFt 1 ATnN
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE OEUVEREOIN
City of Fort Collins
ACCORDANCE WITH THE POLICY PROVISIONS.
Attn: Purchase Dept.
AUTHORIZED REPRESENTATIVE
PO Box 580
Fort Collinsns CO 80524
01988-2615 ACORD CORPORATION. All rights reserved..
ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD