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HomeMy WebLinkAbout262877 RTN ROOFING SYSTEMS LLC - INSURANCE CERTIFICATE (5)ACORO� CERTIFICATE OF LIABILITY INSURANCE �� D /DD/Y 4/24//24/2015 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(ies) must 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 Ewing -Leavitt Insurance Agency 4025 St. Cloud Dr. Suite 100 Loveland CO 80538 CONTACT M n Reee McReynolds NAME: y PHONEE,tI(970) 679-7344 A"C N 866.425.6180 EMAIL .renee-mcReynolds@leavitt.com AbDRESS INSURERS AFFORDING COVERAGE NAIC k INSURER A:Cincinnati Insurance Co 10677 INSURED RTN Roofing Systems, LLC 5854 Lockheed Ave Loveland CO 80538 INSURERB:pinnacol Assurance 41190 INSURER C: INSURER D: INSURER E INSURER F: COVERAGES CERTIFICATE NUMBER:15-16 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. INSR LTR TYPE OF INSURANCE ADDL INSR SUBR ZLM POLICY NUMBER POLICY EFF MMIDD/YYYY POLICY EXP MM/DD/YYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE FX-I OCCUR EPP0322681 /1/2015 /1/2016 DAMAGE RENTED PREMISE Ea occurrence $ 500,000 MED EXP (Any one person) $ 10,000 PERSONAL B ADV INJURY $ 1,000,000 X Blkt Addl Insureds X Blkt Waiver of Sub GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER. PRODUCTS - COMP/OP AGG $ 2,000,000 POLICY X PRO LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident 1,000,000 X BODILY INJURY (Per person) $ A ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS PA0322681 /1/2015 /l/2016 BODILY INJURY (Per accident) $ X PROPERTY DAMAGE Per ac ent $ NON -OWNED AUTOS HIRED AUTOS NX X $ Blkt Addl lnsds BIkt WOS 1 X UMBRELLA LIAB X OCCUR PP0322681 /1/2015 /l/2016 EACH OCCURRENCE $ 1,000,000 AGGREGATE $ 1,000,000 A EXCESS LIAR CLAIMS -MADE DED RETENTION $ $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETORPARTNER/EXECUTIVE 054406 /1/2015 /1/2016 X WC STATU- OTH- E.L. EACH ACCIDENT $ 500,000 OFFICER/MEMBER EXCLUDED? (Mandatory in NH) NIA Incl Blanket Waiver E.L. DISEASE - EA EMPLOYE S 500,000 If yes, describe under DESCRIPTION OF OPERATIONS below f Subrogation 4 E.L. DISEASE - POLICY LIMIT $ 500,000 A Contractors' Equip EPP0322681 /1/2015 /1/2016 Installation Floater $50,000 IimiU$1,000 ded DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) Certificate holder is named additional insured as respects both general and auto liability policies. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Fort Collins ACCORDANCE WITH THE POLICY PROVISIONS. Building Dept PO BOX 580 AUTHORIZED REPRESENTATIVE Fort Collins, CO 80522-0580 R McReynolds/RESTEI�� ACORD 25 (2010/05) INS025 (201005).01 ©1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD