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HomeMy WebLinkAboutTAYLOR KOHRS LLC - INSURANCE CERTIFICATE (4)Client#: 1171319 TAYLOKOHI ACORDTM CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 10/02/2015 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 USI Colorado, LLC Construction P.O. Box 7050 Englewood, CO 80155 CONTACT Client Manager a CC,14 o, Ext): 800 873-8500 ac No): 303-831-5295 E-MAIL ADDRESS: den.contractors@usi.biz 800 873-8500 INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: Valley Forge Insurance Company 20508 INSURED Taylor Kohrs, LLC 12160 Pennsylvania St INSURER B : American Casualty Company of Re 20427 41190 INSURERC: Pinnacol Assurance Company INSURERD: --- Thornton, CO 80241 INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: 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 CONTRACTOR 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. TpR TYPE OF INSURANCE ADDLSUBR INSR WVD POLICY NUMBER POLICY EFF MWDD/YYY POLICY EXP MM/DD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE � OCCUR PD Ded:5,000 X X 6014495066 0/01/2015 10/01/2016 EACH OCCURRENCE $1000000 PREMISES Ea RENTED $100 000 X MED EXP (Any one person) $5 000 PERSONAL & ADV INJURY $1,000,000 GEWL AGGREGATE LIMIT APPLIES PER: POLICY II ECT FI LOC OTHER: GENERAL AGGREGATE $2,000,000 PRODUCTS - COMP/OP AGG $ 2,000,000 $ A AUTOMOBILE LIABILITY ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS HIRED AUTOS X NON -OWNED AUTOS C6014495049 0/01/201510/01/201 CEOMaBBINEocldeSINGLE LIMIT 1,000,000 X BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ X PROPERTY DAMAGE Per accident $ $ B X UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE U6014495052 10/01/2015 10/01/201 EACH OCCURRENCE $10000 000 AGGREGATE $1 O 000 000 DED I X RETENTION $1 O 000 $ C WORKERS COMPENSATION EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE �Y / N OFFICER/MEMBER EXCLUDED? Nl (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below N/A 4096033 10/01 /2015 10/01 /201 X POTH- ERAND E.L. EACH ACCIDENT $1 OOO OOO E.L. DISEASE - EA EMPLOYEE $1,000,000 E.L. DISEASE - POLICY LIMIT $1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) RE: Contractors License City of Fort Collins 215 N. Mason Street 2nd Floor Fort Collins, CO 80524 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 ACORD 25 (2014/01) 1 of 1 #S16386635/M16370599 ©1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD SUKZP