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Home My WebLink About124317 ADVANCED ROOFING TECHNOLOGIES LTD - INSURANCE CERTIFICATE (4)AIllilC40RV CERTIFICATE OF LIABILITY INSURANCE DA3/(3/2016 ) 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 endorsements . PRODUCER CONTACT Mike S erven NAME: Moody Insurance Agency, Inc. 8055 East Tufts Avenue ac NE . (303)824-6600 FAA/C No: (303)370-0118 E-MAIL ADDRESS: Y mike s'erven@mood ins.com Suite 1000 INSURERS AFFORDING COVERAGE NAIC# INSURERA:Cincinnati Specialty Underwriters 13037 Denver CO 80237 INSURED INSURERB:Natl Union Fire Ins Co of Pitt 19445 INSURER C:WesItches ter Surplus Lines Insurance 10172 Advanced Roofing Technologies LTD. INSURER D: 4496 Bents Drive Unit C INSURER E : Windsor CO 80550 1 INSURER F: COVERAGES CERTIFICATE NUMBER:16-17 w/forms REVISION NIIMRFR- 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 SUBR POLICY NUMBER POLICY EFF MM/DD/VYYY POLICY EXP MM/DD/YYYY1 LIMITS X COMMERCIAL GENERAL LIABILITY RRENCE $ 1,000,000 A CLAIMS -MADE � OCCUR RENTED Ea occurrence $ 100, 000 n one person) rGENERAL $ 2,000 X CS00055744 3/4/2016 3/1/2017 B ADV INJURY $ 1,000,000 Additional Insured staus GENT AGGREGATE LIMIT APPLIES PER: POLICY 111 JEC LOC GGREGATE $ 2,000,000 applies only to the extent provided in PRODUCTS - COMP/OP AGG $ 2,000,000 Employee Benefits 5 1,000,000 OTHER: form CSIA405 08-09 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ BODILY INJURY (Per person) $ ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS X BODILY INJURY Per accident ( ) S PROPERTY DAMAGE Peraccident $ NON -OWNED HIRED AUTOS AUTOS S X UMBRELLA LAB X OCCUR EACH OCCURRENCE $ 2,000,000 AGGREGATE $ 2,000,000 B EXCESS LIAB CLAIMS -MADE DED RETENTION$ $ BE011573466 3/4/2016 3/1/2017 WORKERS COMPENSATION PER OTH- AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR)PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? Li N/A STATUTE ER E.L. EACH ACCIDENT S E.L. DISEASE - EA EMPLOYE $ (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below I E.L. DISEASE - POLICY LIMIT $ C Pollution Liability G27908524001 3/1/2016 3/1/2017 Limit 1,000,000 Deductible 10,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) City of Fort Collins is named as Additional Insured with regards to General Liability and Auto Liability when required by written contract. l an I IrnVm 1 a nULUCPI 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. AUTHORIZED REPRESENTATIVE Sjerven/DONBRI — ----�' ACORD 25 (2014/01) INS025 (201401) U 1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD ACORD. CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/1'1YY) 02/25/2016 PRODUCER 5of Assurance 701 E Lowry Blvd Denver, CO 80230-7006 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE NAIC# INSURED INSURERA: Plnnacol Assurance 41190 Advanced Roofing Technologies Ltd 4496 Bents Dr Unit C Windsor, CO 80550 INSURERB: INSURER C: INSURER D: INSURER E' COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDNG ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMMENT 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 ADDi POLICY EFFECTIVE POLICY EXPIRATION LTR INSRD TYPE OF INSURANCE POLICY NUMBER DATE(MMIDDIVVVY) DATE(MMIDD/YYYY) LIMITS GENERAL LIABILITY EACH OCCURRENCE DAMAGE TO RENTED COMMERCIAL GENERAL LIABILITY CLAIMS MADE OCCUR PREMISES MED EXP(Any one erson) PERSONAL A ADV INJURY GEN'L AGGREGATE LIMIT APPLIERS PER: GENERAL AGGREGATE PRODUCTS-COMP/OP AGG POLICY PROJECT LOC AUTOMOBILE LABILITY COMBINED SINGLE LIMIT ANY AUTO (Es Accident) ' BODILY INJURY ALL OWNED AUTOS SCHEDULED AUTOS (Per person) BODILY INJURY HIRED AUTOS NON�OWNED AUTOS (Per accident) PROPERTY DAMAGE (Per accident) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT OTHER THAN EA ACC ANY AUTO AUTO ONLY: AG EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE AGGREGATE OCCUR CLAIMS MADE DEDUCTIBLE RETENTION $ WORKERS COMPENSATION AND WC STATU- OTHER A EMPLOYER'S LABILITY ANY PROPRIETOR/PARTNERIEXECUTIVE 4098470 03/01/2016 03/01/2017 TORY LIMITS El EACH ACCIDENT $1,000,000 El DISEASE- EA EMPLOYEE $1,000,000 OFFICER/MEMBER EXCLUDED? E.L DISEASE -POLICY LIMIT 1000000 If yes, pleesedescnbeunder SPECIAL PROVISIONS below OTHER DESCRIPTION OF OPERATIONSILOCATIONSNEHICLESIEXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION 1681506 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, THE ISSUING COMPANY WILL ENDEAVOR TO NOTIFY 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO NOTIFY SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE Jeff Bunn ACORD 25(2001/08) Underwriter ACORD CORPORATION 1988