Loading...
HomeMy WebLinkAbout432047 ALL PHASE RESTORATION - INSURANCE CERTIFICATE (4)AC<> o® CERTIFICATE OF LIABILITY INSURANCE TE F DA2/2M2016n 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 endersement(s). PRODUCER Flood and Peterson PO Box 578 Greeley CO 80632 CONTACT Dana Stewart CIC CISR NAAME:ME: PHONE-(970)266-7149 FAX AIC No:(970)506-6845 ADDRESS:DStewart@floodpeterson.com INSURERS AFFORDING COVERAGE NAIC p INSURERAArch Specialty Insurance Company 21199 INSURED All Phase Restoration, Inc. 7355 Greenridge Road, Unit C Windsor CO 80550 INSURERB:Union Insurance Company 25844 INSURERC:Pinnacol Assurance 41190 INSURERD: INSURERE: INSURERF: COVERAGES CERTIFICATE NUMBER�2.162208786 REVISION NUMRER: 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 rypE OF INSURANCE ADDL SUER POLICY NUMBER POLICY EFF IMM/DD POLICY EXP MM/DDIYYYY LIMITS A R COMMERCIALGENERAL LIABILITY CLAIMS -MADE OCCUR Deductible: $10,000 12 EMP 05485 00 10/22/2015 10/22/2016 EACH OCCURRENCE $ 2,000, 000 DAMAGE TO RENTED PREMISES RENT occurrence)$ 50,000 R MED EXP(Any one person) $ 5,000 R Blanket Al 6 WOS PERSONAL B ADV INJURY $ 2,000,000 GENT AGGREGATE LIMIT APPLIES PER: POLICY JEO- LOC OTHER: GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP/OP AGG $ 2,000,000 $ B AUTOMOBILE LIABILITY ANY AUTO ALLOWNEDAUTOS SCHEDULED AUTSCPA HIRED AUTOS R NON -OWNED AUTOS 3112817-20 SO/22/2015 10/22/2016 EO BINEDt SINGLE LIMIT $ 1,000,000 BODILY INJURY(Per person) $ Ix BODILY INJURY (Per accident) S PROPERTY DAMAGE Per accident $ E A X UMBRELLA LIAB EXCESS LIAB R OCCUR CLAIMS -MADE 1 112 EMX 05486 00 10/22/2015 10/22/2016 EACH OCCURRENCE $ 3,000,000 AGGREGATE $ 3 000 0-00 DIED I RETENTION$ 0 $ C WORKERS COMPENSATION ANDEMPLOYERS'LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICERIMEMBER EXCLUDED? ❑ (Mandatory in NH) 0 yyes describe under DES,RIPIION OF OPERATIONS below NIA 4107070 3/1/2016 3/1/2017 R PER OTH- STATUTE ER E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE - POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space is required) SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Fort Collins THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN P.O. BOX 580 ACCORDANCE WITH THE POLICY PROVISIONS. Fort Collins, CO 80522 AUTHORIZED REPRESENTATIVE N Rolph, CISR/NROLPH ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD I NS025 r2n14nn