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HomeMy WebLinkAboutBLM CONSTRUCTION - INSURANCE CERTIFICATE (2)BLMCONS-01 SDUNN ,a►o�_ CERTIFICATE OF LIABILITY INSURANCE 1641 DAT/YYYY) 12/9/20/9/2015 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 PFSlnsurance Group 4848 Thompson Parkway Suite 200 Johnstown, CO 80634 CONTACT _ NAME: Sharon Dunn - PHONE FAX A/c Na Ext:(970) 635-9400 A/c No: (970) 635-9401 bmDAREss: info@mypfsinsurance.com INSURER(S) AFFORDING COVERAGE - NAIC # INSURER A: Liberty Mutual Group 41785 INSURED INSURER B Blm Construction John Davidson INSURER C 614 Locust Street INSURER 0: INSURER E: Fort Collins, CO 80524 INSURER F : COVERAGES CERTIFICATE NUMRER- RFVISInN nnIMRFR- 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. 1�7p TYPE OF INSURANCE p yWp POLICY NUMBER MM DDY/YYYY MM DD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE O OCCUR BKS55733734 12/13/2015 - 12/13/2016 EACH OCCURRENCE $ 1,000,000 PREMISES Eeoocunence $ 300,000 MED EXP (Any one person) $ - 15,000 PERSONAL & ADV INJURY $ 1,000,000 GENT AGGREGATE LIMIT APPLIES PER: POLICY PRO JECT N LOC OTHER: GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP/OP AGG $ 2,000,000 Terrorism $ AUTOMOBILE LIABILITY ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS HIRED AUTOS NON -OWNED AUTOS COMBINED SINGLE LIMIT Ea accident $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION AND EMPLOYERTLIABILITY Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICERIMEMBER EXCLUDED? 71 (M If yandatory In NMI DESs, describe CRIPTION OF OrPERATIONS below N/A PERT OTH- STUTE ER E.L. EACH ACCIDENT - $ EA E.L. DISSE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required) carpentry interior VCR i Ir 1VN 1 C nVLUCK GAN%,c LLA 11VIV City of Fort Collins P.O. 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 ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD