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HomeMy WebLinkAboutD & D ROOFING INC - INSURANCE CERTIFICATE (5)P52601210a12 8 7 DATE (MMIDDIYYYY) ACC>RL7nCERTIFICATE OF LIABILITY INSURANCE 10/O1/2015 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 1-303-534-4567 CONTACT NAME: INA, Inc. - Colorado Division PHONE FAX WC. NQ EX i A/C No E-MAIL denaccounttecho@imacorp.com 17th Street ADDRESS: rp•com Suite 100 INSURERS AFFORDING COVERAGE NAIC # Denver, CO 80202 INSURERA: WESTFIELD INS CO 24112 INSURED MSURERB: NATIONAL UNION FIRE INS CO OF PITTS(All 19445 D&D Roofing Inc. INSURER C 6270 E. 50th Ave. INSURER D: INSURER E : Commerce City, CO 80022 INSURER F: COVERAGES CERTIFICATE NUMRER- 45165553 RFVISION NIIIMRFR- 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 TYPE OF INSURANCE ADDL SUBR _--- POLICY EFF POLICY EXP LTR POLICY NUMBER MMIDD MMIDD LIMITS A X COMMERCIAL GENERAL LIABILITY CXK1827928 10/01/15 10/01/16 EACH OCCURRENCE f 1,000,000 CLAIMS -MADE ril OCCUR DAMAGE TO R PREMISES Ea occurrence $ 500,000 X MED EXP (Any one person) $ 5,000 PD Ded: $10, 000 PERSONAL BADVINJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY X PRO- JECT LOC PRODUCTS - COMWOP AGG f 2,000,000 f OTHER. A AUTOMOBILE _ LIABILITY CMK1827928 10/01/15 10/01/16 COMBINED SINGLE LIMIT Ea accident = 1,000,000 BODILY INJURY (Per person) _ X ANY AUTO _ ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ X X NON -OWNED HIRED AUTOS AUTOS PROPERTY DAMAGE Per accident __.._ s S B UMBRELLA LIAB X OCCUR EBU036024849 10/01/15 10/01/16 EACH OCCURRENCE $ 1,000,000 AGGREGATE $ 1,000,000 X EXCESS UAB CLAIMS -MADE $ DED RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LUIBILITY YIN PER OTH- STATUTE E.L. EACH ACCIDENT i ANY PROPRIETORRARTNERIEXECUTIVE /M OFFICEREMBER EXCLUDED' NIA E.L. DISEASE - EA EMPLOYE i (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT 1 i DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required) City of Fort Collins is included as Additional Insured on the General Liability Policy if required by written contract or agreement and with respect to work performed by insured subject to the policy terms and conditions. 1 t t1ULUtK City of Fort Collins 215 North Mason Street, 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. AUTHORIZED REPRESENTATIVE MIR USA ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD ashmcclain 45165553 a, 0 z W