HomeMy WebLinkAbout109363 ALLIANCE CONSTRUCTION SOLUTIONS LLC - INSURANCE CERTIFICATE (5)AC40R& CERTIFICATE OF LIABILITY INSURANCE
1`.�
DATE(MMDD/YYYY)
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THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATIONONLY 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 pollcy(ies) must have ADDITIONAL INSURED provisions or be endorsed.
If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain' policies may requiwan endorsement. A statement on
this, certificate:does not confer _rights to the certiticate,holderin Ileu of such: endorsements : _-..._...._ .....
PRODUCER -
Innovise Business Consultants.
6600 E, Hampden Ave
Denver CO 80224
N ME: Mary Cole .. - .
PHONE. . 720-401r8022_ .FAX
Alc No:
ADoREss: rncole trustinnovise.cam
INSURERS AFFORDING COVERAGE
NAIC a
INSURERA: Liberty Mutual Fire Insurance Company
23035
INSURED ALLICON-02
Alliance Construction Solutions, LLC
12789 Emerson Street
.INSURER a : Charter Oak Fire Insurance Co.
2561fi
INSURERC:
INSURERD:
Thornton CO 80241
INSURERE:
'INSURER F:
COVERAGES CERTIFICATE NUMBER: 824015675 REVISION NUMBER: 002
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 ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THETERMS,
EXCLUSIONS AND CONDITIONS OF:SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR
LTR
TYPE OFINSURANCE
ADOL
I
SU R
POLICY NUMBER
POLICY EFF
DIYY
POLICcY EXP
MMIDD/YY.
Uh9T5
A
X COMMERCIAL GENERAL LIABILITY
TB2-Z91466781-020
1/1/2020
111/2021
FJICHOCCURRENCE
$2.000,000;
CLAIMS -MADE ETI OCCUR
I PREMISES Ea occurrence
$2,000,000'
MED. EXP (Any oneperson)
$10,000
PERSONAL .B'ADVWINJURY
$2.000;000,
GEN'L AGGREGATE LIMIT APPLIES. PER:.
GENERAL AGGREGATE
$4,000,000
POLICY � JECT LOC
PRODUCTS-COMP/OP.AGO
E4;000,ODO
OTHER;
A
AUTOMOBILE
LIABILITY
AS2=Z91466781-010
1/112020
111/2021
a COMBINcidentED SINGLE LIMIT
Eac
$1.000.000
X
BODILY INJURY (Pet person)
. $
ANY ALTO
OWNED F7 SCHEDULED
AUTOS ONLY AUTOS
BODILY INJURY (Per accident)
S
X
PROPER TYDAMAGE
lPer accident
$
HIRED X NON -OWNED
AUTOS ONLY --• AUTOS ONLY
A
X
UMBRELLA, LIAR
X
OCCUR
TH7-Z91-466781.039
111/2020
111&21 -
FACHOCCURRENCE
$10:000,000...
AGGREGATE
$
EXCESS LIAR
i CLAIMB•MADE
DED I X I RETENTION $`.in nnn$..
A
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY Y I N
ANYPROPRIETOR/PARTNER'EXECUTIVE
WC2-Z91466781.050
1/112020
11.112021
STaruTE EA
E.L. EACH ACCIDENT
$1,000,000
OFFICERIMEMBEREXCLUDEDT
(Mandatory In NM
N/A
E.L. DISEASE - EA EMPLOYEE
$1,000,000
It yes; descrlbe under
DESCRIPTION OF OPERATIONS below
-
.. _..
..
-
�.E.L'. DISEASES POLICY. LIMIT
$1.000.000 _
B
Leased 8 Rented
oT-660.6G309197-COF-19
11112121
1112021
$350.000 per Item
Crane -
$350,000 aggregate
$5,000 Deductible
Contractor; Equipment
$1,000 Deductible
DESCRIPTION OP OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Addillonel Remarks Schedule, maybe attached If more space la required)
RE: Contractor's License A-96
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
PO Box 580 AUTHORIZED EPRESENTAnVE
Fort Collins CO 80522-0580 �.��f��`��
ACORD 25 (2016/03)
The ACORD name and logo are registered marks of ACORD
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