Loading...
HomeMy WebLinkAboutFOSTER AND SON PLUMBING INC - INSURANCE CERTIFICATE (2)FOSTE-2 OP ID: SJR ,4coRO° CERTIFICATE OF LIABILITY INSURANCE DATE 0511M51201/DDNYY) 05/15/2015 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 CRS Insurance Brokerage Commercial Risk Solutions DBA CONTANAME: Eric Johnson, CIC PHONE 303-996-7801 aC No ; 303-757 7719 A/c No Ext 6600 E. Hampden Ave. Denver, CO 80224 E-MAIL ADDRESS: Eric Johnson, CIC INSUREl AFFORDING COVERAGE NAIC A INSURER A: Liberty Mutual Group 23043 INSURED Foster and Son Plumbing, Inc. INSURERS: Pinnacol Assurance Kurt Foster 2111 South Trenton Way Ste 108 INSURERC: Denver, CO 80231 INSURER D : INSURER E INSURER F : COVERAGES CERTIFICATE NUMBER: 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 UB POLICY NUMBER POLICY EFF MM/DDNYYY POLICY EXP MM/DD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE I - - ;. OCCUR X BKS55601689 06/03/2015 06/03/2016 EACH OCCURRENCE $ 1,000,00 DAMAGE T RENTED PREMISES Ea occurrence $ 300,00 MED EXP (Any one person) $ 15,00 PERSONAL BADVINJURY $ 1,000,00 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY � JECOT- LOC OTHER. GENERAL AGGREGATE $ 2,000,00 PRODUCTS -COMP/OP AGG $ 2,000,00 $ A AUTOMOBILE LIABILITY ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS X NON -OWNED HIREDAUTOS AUTOS BA6784096 06/03/2015 06/03/2016 COMBINED SINGLE LIMIT Ea accident $ 1,000,00 X BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ X PROPERTY DAMAGE Per accident $ A X UMBRELLA LIAB EXCESS LAB X OCCUR CLAIMS -MADE US055601689 06/03/2015 06/03/2016 EACH OCCURRENCE $ 3,000,00 AGGREGATE $ 3,00.0_,0. 0 DED X I RETENTION $ 10,000 $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y/Y❑N /M OFFICEREMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N/A 4148484 06/01/2015 06/01/2016 X PER OTH- STATUTE ER E.L.EACH ACCIDENT $ 1,000,00 E.L. DISEASE - EA EMPLOYEE $ 1,000,00 E L DSEASE - POLICY LIMIT $ 1,000,00 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) City of Fort Collins is included as additional insured for ongoing operations on the General Liability with respect to operations of the named insured for the certificate holder as required by written contract. All policy terms, conditions and exclusions apply. UICK I II-II.A I t NULl GANGtLLA I IUN CITYFTC 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. 300 LaPorte Avenue Fort Collins, CO 80521 AUTHORIZED REPRESENTATIVE © 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD