HomeMy WebLinkAboutH&M MECHANICAL LLC - INSURANCE CERTIFICATE (4)ACC> " CERTIFICATE OF LIABILITY INSURANCE FDATE
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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 CONTNAME, Brandie Zuckerman, CRIS
Moody Insurance Agency, Inc. PHCN c (303) 824-6600 FAX
No: (303)370-0118
8055 East Tufts Avenue E-MAIL ADDRESS: brandie.zuckerman@moodY ins.com
Suite 1000 INSURERS AFFORDING COVERAGE NAIC#
Denver CO 80237 INSURERA:Union Insurance Co 25844
INSURED INSURER B Acadia Insurance Company 31325
H&M Mechanical, LLC INSURERC:
108 E Emma Street INSURER0:
Lafayette CO 80026 I INSURERF:
COVERAGES CFRTIFICATF NIIMRFR•15-16 Master DG\1Iclnn1 nIIIReDCD.
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.
TR
TYPE OF INSURANCE
AD L
U
NUMBER
LICY EFF
POPOLICY
MM/DD/YYYY
POLICY EXP
MM/DDNYYY
LIMITS
A
X
COMMERCIAL GENERAL LIABILITY
CLAIMS MADE X OCCUR
EACH OCCURRENCE
$ 1,000,000
DAMAGE TO RENTED
PREMISES Ea occurrence
$ 300,000
MED EXP (Any one person
$ 10,000
CPA3068937-22
8/1/2015
8/1/2016
PERSONAL & ADV INJURY
$ 1,000,000
GEN'L
X
AGGREGATE LIMIT APPLIES PER:
POLICY PRO-
JECT LOC
1:1 ❑
GENERAL AGGREGATE
$ 2,000,000
PRO DUCTS-COMPlOPAGG
$ 2,000,000
$
OTHER:
AUTOMOBILE
LIABILITY
(Ea BIKED SINGLE LIMIT
$ 1,000,000
X
BODILY INJURY (Per person)
$
A
ANY AUTO
ALL OWNED SCHEDULED
AUTOS AUTOS
CPA3068937-22
8/1/2015
8/1/2016
BODILY INJURY Per accident
( )
$
HIRED AUTOS NON -OWNED
AUTOS
X
PROPERTY DAMAGE
Per accident
$
$
X
UMBRELLA LIAB
OCCUR
EACH OCCURRENCE
$ 3,000,000
AGGREGATE
$ 3,000,000
A
EXCESS LIAB
CLAIMS -MADE
DED RETENTION$
$
CPA3068937-22
8/1/2015
8/1/2016
B
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY Y/ N
ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICER/MEMBER EXCLUDED?
(Mandatory in NH)
If yes, describe under
DESCRIPTION OF OPERATIONS below
N/A
I
I
WCA3103928-21
I
8/1/2015
I
8/1/2016
ER 0 H-
XISTATUTE I I ER
E.L. EACH ACCIDENT
$ 500,000
E.L. DISEASE - EA EMPLOYE
$ 500,000
E.L. DISEASE - POLICY LIMIT
-
$ 500,000
DESCRIPTION OF OPERATIONS! LOCATIONS! VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
r rvw�n l.AV4t r_LLA 1 IUN
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
Fort Collins THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
PO BOX 580 ACCORDANCE WITH THE POLICY PROVISIONS.
Ft. Collins, CO 80522
AUTHORIZED REPRESENTATIVE
B Zuckerman, CRIS/BRAS
V 19S8-2014 ACORD CORPORATION. All rights reserved.
ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD
INS025 (201401)