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Home My WebLink About201461 CONSTRUCTION CONCEPTS INC - INSURANCE CERTIFICATE (9)A f RV 4 DATE (MMIDD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 9/30/2015 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: Karole Peters FA Ewing -Leavitt Insurance Agency PHONE (970) 679-7355 A/C No: (866)237-2178 4025 St. Cloud Dr. E-MAIL karole-peters@leavitt.com ADDRESS: _ Suite 100 INSURERS AFFORDING COVERAGE NAIC # Loveland CO 80538 INSURERA:Cincinnati Insurance Co 10677 INSURED INSURERB:Pinnacol Assurance 41190 Construction Concepts Inc INSURER C:Atlantic Specialty Insurance 27154 14125 Mead Street INSURERD: INSURER E : Longmont CO 80504 1 INSURER F: COVERAGES CERTIFICATE NUMBER:15-16 All 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'SU D POLICY NUMBER MM% DPOLICYEFF /YYYY POLICY MM EXP / D/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE FX7 OCCUR Blkt Addl Insured EPP0162368 10/1/2015 10/1/2016 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTE PREMISES Ea occur ante $ 500,000 X MED EXP (Any one person) $ 10,000 X Blkt Waiver of Sub PERSONAL & ADV INJURY $ 1,000,000 GEN'LAGGREGATE LIMIT APPLIES PER: X POLICY FX� JECT LOC OTHER: GENERAL AGGREGATE $ 2,000,000 PRODUCTS-COMP/OPAGG $ 2,000,000 $ AAUTOMOBILE LIABILITY X ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS X HIRED AUTOS X NON -OWNED AUTOS X Blkt At X Blkt WOS EPP0162368 10/1/2015 10/1/2016 MNED SINGLE LIMIT Ea accident $ 1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident — _ $ $ A X UMBRELLA LAB EXCESS LIAB X OCCUR CLAIMS -MADE EPP0162368 10/1/2015 10/l/2016 EACH OCCURRENCE $ 2,000,000 AGGREGATE $ 2,000,000 DED I X I RETENTION $ 0 $ 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 4031745 Blanket Waiver of Subrogation. 7/1/2015 7/l/2016 XPER STATUTE ERH E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYE $ 1,000,000 E.L. DISEASE - POLICY LIMIT 1 $ 11000,000 C Builders Risk -Reporting 790-01-03-05-0004 10/1/2015 10/1/2016 Any One Structure ($1,000 ded) $1,500,000 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) rPPTIFICATF HnI nFR rANCFI 1 ATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Fort Collins THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Purchasing Division ACCORDANCE WITH THE POLICY PROVISIONS. 215 N. Mason Street AUTHORIZED REPRESENTATIVE 2nd Floor Fort Collins, CO 80524 Karole Peters/KAPETE U 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD INS025 (201401)