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HomeMy WebLinkAbout414575 MAXIMUM PAINTING LLC - INSURANCE CERTIFICATE (6).a`oRo® CERTIFICATE OF LIABILITY INSURANCE DATE /07/D0PIVVYj 04/Q7/Y020 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 certificate does not confer rights to the certificate holder In lieu of such endorsement(s). PRODUCER CONTACT NAME " Shannon Kammerer' Flood. and Peterson. ENE o.ExtI: (970) 356A723 FAX (970),330-1867 PO Box578 E' ADDRESS: -SKammerer(dlfioodpetersorl.com - .ANSI S AFFORDING COVERAGE_ __. _.._NAICA_ INSURERA: WlBstfield Insurance Company 24112 Greeley CO 80632 INSURED INSURERB: Pinnacol Assurance 41190 INSURER C : Maximum Painting, LLC INSURER D: 412. S. Howes St, Ste. C INSURER E : INSURER F— _- _ �- -_--------- -- - _ - �- --- Fort Collins CO 80521 COVERAGES CERTIFICATE NUMBER: x12/1/19-20 Master REVISION NUMBER: THIS IS TO CERTIFY THATTHE POLICIES OF INSURANCE. LISTED BELOW HAVE BEEN ISSUED TO THEINSURED 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 13EEN REDUCED BY PAID CLAIMS. 7SI TYPE OF INSURANCE 1 POLICY.NUMBER. _- ___ POLICY OLI .. iD YEF .: POUC .. - - ..LIMITS.. _ CO_MMERCU\L.EACH OCCURRENCE. E 1,000,000 CLAIMS -MADE OCCUR DAMAGE TO RENTEu PREMISES Es occurrence $ 500,000 MED EXP (Any onePerson) g 5,000 PERSONAL &ADV INJURY $ 1,000,000' A TRA3290427 - 12/01/2014 12/01/2020 GEN'LAGGREGATE LIMIT APPLIES PER: - " - GENERALAGGREGATE . . $ 2,000,000PR - POLICY 19 J CT E]LOC .PRODUCTS-COMP/OP.AGG_ .E_- E 1'000',000 ..OTHER: __ I- I - -I AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident S 1.,000,000 -- BODILY INJURY (Per Person) E ANY AUTO A OWNm X SCHEDULED AUTOS ONLY AUTOS TRA3290427 12/01/2019 - - 12/61/2020 - BODILY INJURY (per accident) E " PROPERTY DAMAGE Per acdtlent- $ HIRED NON -OWNED AUTOS ONLY X AUTOS ONLY --_._.._._- E. __ UMBRELLA LUAB OCCUR EACH OCCURRENCE E'5,000,000 AGGREGATE E 5,000,000 A EXCESS UAB CLAIMS•MADE TRA3290427 1V01/2019 12/01/2020 DED X .RETENTION E 0 E B -- WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNER/EJECUTIVE OFFICER/MEMBEREXCLUDED? � (Mandatory In NH) NIA 4104129 05/01/2020 05/01/2021 X S7q UTE 7 ERµ EL EACH ACCIDENT _ _ _ E .1,000,000 - - E.L.DISEASE - EA EMPLOYEE S 1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below EL DISEASE- POLICY LIMIT S 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached B mom span is required) Certificate holder is included as Additional Insured as required by written Contract with respects to liability arising out of work performed by the named insured, respects to the Auto Liability and General Liability policies. SHOULOANY OFTHE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF NOTICE WILL dilf DELIVERED IN City of Fort Collins ACCORDANCE WITH THE POLICY PROVISIONS. P.O. Box 580 AUTHORIZED REPRESENTATIVE Fort Collins CO 80522 -.0 y.-..._e,.e ©1988-2015 ACORD CORPORATION. All rights reser ACORD 15 (2015/03) The ACORD name and logo are registered marks of ACORD