Loading...
HomeMy WebLinkAboutSYMMETRY BUILDERS INC - INSURANCE CERTIFICATEA�� ® 78/6/2015 TE (MM/DD/YYYY) C" CERTIFICATE OF LIABILITY INSURANCE 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 CONTACT Pam Thom son NAME: P IRG Underwriters, LLC PHC.No Ext: (720) 403-9450 AC No: (720)403-9451 6501 E. Belleview Ave. E-MAIL ADDRESS: Pthorn son@landmarkins rou corn P g P Suite 550 INSURER(S) AFFORDING COVERAGE NAIC# Englewood CO 80111 INSURERA:Travelers INSURED INSURERB:Plnnacol Assurance Symmetry Builders Inc INSURERC: Po BOX 20095 INSURERD: Boulder CO 80308-3095 1 INSURERF: COVERAGES CERTIFICATE NUMBER:CL158602283 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 SUBR POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DD/YYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A CLAIMS -MADE X I OCCUR DAMAGE TOEa RENTED PREMISES occurrence $ 300,000 MED EXP (Any one person) $ 10,000 DCOBE728083 8/1/2015 8/1/2016 PERSONAL & ADV INJURY $ 1,000,000 GEN'LAGGREGATELIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY FX7 PE LOC PRODUCTS -COMP/OP AGG $ 2,000,000 Limited Jobsite Pollution $ Included OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ 1,000,000 BODILY INJURY (Per person) $ A X ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS BA8E72808315 8/1/2015 8/1/2016 BODILY INJURY (Per accident) $ PROPERTY DAMAGE APer accident $ X NON -OWNED HIRED AUTOS FX AUTOS $ 1,000,000 X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 3,000,000 AGGREGATE $ 3,000,000 A EXCESS LIAB CLAIMS -MADE CUP8E728083 8/1/2015 8/1/2016 DED 1 X RETENTION$ 10,000 $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N X PER OTH- STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $ 500,000 B OFFICER/MEMBER EXCLUDED9 ❑ (Mandatory in NH) N/A 4149832 8/1/2015 8/1/2016 E.L. DISEASE- EA EMPLOYEE $ 500,000 If yes, describe under I DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 500,000 A Contractors Equipment DCOSE728083 8/1/2015 I 8/1/2016 Blanket Leased/Rented $100,000 Deductible $1, 000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) RE: License Kim q;IIIaPiIM;Lei 41Ja: tl11►Nla4IWiILillJC City of Fort Collins Colorado PO Box 580 281 N College Ave Fort Collins, CO 81524 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE Pam Thompson/PATH01--C—)Q'-,i-x- © 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD INS025 (201401)