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HomeMy WebLinkAboutMCDAVID CONSTRUCTION INC - INSURANCE CERTIFICATE (4)ACC o® CERTIFICATE OF LIABILITY INSURANCE DATE,MM/DD/YYYY) 8/31/2015 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 - LeBaron S Carroll, LLC 1350 E: Southern Ave. Mesa AZ 85204 CONTACT ,TaniVolpe,CIC, CISR NAME: Ce PHONE (480) B34-9315 FAX, N Exit, JAIC No: (4e0)844-9866 EMAIL jvolpe@landc.com ADDRESS: P INSURERS AFFORDING COVERAGE NAIC 0 INSURERAAllied Insurance INSURED McDavid Construction, Inc. 2239 E. Rose Garden Loop Phoenix AZ 85204 INSURER B:CO pint General Ins Cc INSURER C: INSURER D: INSURER E: INSURERF: nnVFRAnFc r:FRTIFIrATF NIIMRFR•2014/2015 REVISED 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 ADD UBR POLICY NUMBER POLICY EFF POLICMM DDY EXP LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE E 1,000,000 DAMAGE TO RENTED 100, 000 A CLAIMS -MADE OCCUR PR M SES Ea occurrence E MED EXP (Any one person) $ 5, 000 ACP3006959762 12/18/2014 12/18/2015 PERSONAL B ADV INJURY E 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE E 2,000,000 PRODUCTS - COMP/OPAGG $ 2,000,000, PIPOLICY E]JECT � LOC PI $ OTHER i� .. - AUTOMOBILE LIABILITY "" ", - COMBINED SINGLE LIMIT Ea accident E - 1, 000, 000� BODILY INJURY (Per person) E X ANY AUTO A BODILY INJURY (Per accident) E ALL OWNED SCHEDAUTOSULED . ACP3006959762 12/18/2014 12/18/2015 AUTOS NON -OWNED PROPERTY DAMAGE Per accident $ HIREDAUTOS AUTOS Miscellaneous Charges $ X UMBRELLA UAB OCCUR EACH OCCURRENCE $ 2,000,000 AGGREGATE E 2,000,000 A EXCESS LIAB CLAIMS -MADE LIED I I RETENTIONS $ ACP3006959762 12/18/2014 12/18/2015 WORKERS COMPENSATION PER O STATUTE EERRT AND EMPLOYERT UABIUTY YIN ANY PROPRIETOR/PARTNERIEXECUTIVE E.L. EACH ACCIDENT It 1 000 000 B OFFICERIMEMBER EXCLUDED? (Mandatory in NH) NIA 1017576 9/1/2015 9/1/2016 E.L. DISEASE - EA EMPLOYE E 1 000 000 E.L. DISEASE - POLICY LIMIT $ 1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below - A Leased/Rented Equipment ACP3006959762 12/18/2014 12/18/2015 Limit $50,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached U more space Is required) CFRTIFICATF 1.101 nFR CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Fort Collins THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN PO Box 580 ACCORDANCE WITH THE POLICY PROVISIONS. Fort Collins, CO 80526 AUTHORIZED REPRESENTATIVE S Perkinson/EMILY ACORD 25 (2014/01) INS025 (201401) ©1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD