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HomeMy WebLinkAboutHARRIS HOMES INC DBA HARRIS CONSTRUCTORS - INSURANCE CERTIFICATE (2)ACOR" CERTIFICATE OF LIABILITY INSURANCE DATE (MMlDD WYY) 1' 08/20/2015 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 CONTACT NAME: Brandi Markley PHONE 'X ,CC.No Ell, 970-378-4818 (AIC,No): 970-378-4820 Security Insurance Group, LLC 8219 W 20th St, Ste A E-MAIL ADDRESS: sig@securityinsurancegroup.net Greeley, CO 80634 INSURERS AFFORDING COVERAGE NAIC # INSURER A: Western Pacific Inc. Network INSURED INSURERB: Auto Owners Insurance 32700 Harris Homes, Inc INsuRERc: Pinnacol Assurance DBA Harris Constructors PO Box 336751 INSURER D : Greeley, CO 80633-0613 INSURERE: INSURER F : COVERAGES CERTIFICATE NUMBER: 00001168-265071 REVISION NUMBER: 2 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 OF INSURANCE ADDLTYPE INSR SUBR POLICY NUMBER Y EFF MMIDD/YYYY POLICY MIDDEXP YYYY LIMITS A GENERAL LIABILITY X1 COMMERCIAL GENERAL LIABILITY CLAIMS -MADE 7 OCCUR GLP010802404 08/01/2015 08/01/2016 EACH OCCURRENCE $ 1,000,000 DAMAGE To RENTED PREM SES (E. occurrence) $ 300,000 MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY s 1,000,000 GENERAL AGGREGATE S 2,000.000 GEN'L AGGREGATE LIMIT APPLIES PER: X POLICY PRO LOC JECT PRODUCTS - COMP/OP AGG S 2,000,000 $ B AUTOMOBILE LIABILITY X ANY AUTO OWNEDALL X AUTOS AUTOSCHEDULED X HIRED AUTOS X AUTOS ED 4817431500 10/15/2li 10/1512015 (Ea accciden SINGLE LIMIT $ BODILY INJURY (Per person) S 1,000,000 BODILY INJURY (Per accident) S 1,000,000 Feo,acEcid nDAMAGE St) 1,000,000 S A X UMBRELLA LIAB OCCUR EXCESS LIAB X CLAIMS -MADE BE012060163 08/01/2015 08/01/2016 EACH OCCURRENCE $ 5,000,000 AGGREGATE S 5,000,000 DIED RETENTION $ s `+ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ OFFICER/MEMBER EXCLUDED*) (Mandatory in Ni If yes, describe under DESCRIPTION OF OPERATIONS below N/A 4115070 06/01/2015 06/01/2016 X VAC STATU- OTH- E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE S 1,000,000 E.L. DISEASE -POLICY LIMIT S 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, it more space is required) City of Fort Collins PO Box 580 Fort Collins, CO 80522 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 'ci d" BJM ©1988-2010 ACORD iftPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD Printed by BJM on August 20, 2015 at 10.04AM