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HomeMy WebLinkAboutCALVIN TURNER ROOFING LLC - INSURANCE CERTIFICATE (2)A� 0r CERTIFICATE OF LIABILITY INSURANCE Dav27/2o 6 ) 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 NAME: Rochelle Romero High Desert Agencies LLC 102 S Victoria PHONE (719)582-1070 AIAX No: (719)582-1071 AbDRESS:Rochelle@GoHighDesert INSURERS AFFORDING COVERAGE NAIC 0 Suite 150 INSURERA:Gemini Insurance Company Pueblo CO 81003 INSURED INSURER B Mountain States Insurance Group Calvin Turner Roofing LLC INSURER C: 3128 W. 12th St. INSURERD: INSURER E : INSURER F: Pueblo CO 81003 GUVERAGES CFRTIFICATF NI IMRFR•15-17 D=11I¢InK1 NI IMDGD- 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 POLICY EXP MM LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A CLAIMS -MADE FxIOCCUR DAMAGE TO RENTED PREMISES PREMISES Ea occurrence $ MED FRCP (Any one person) $ 5,000 VIGPO17296 1/5/2016 1/5/2017 PERSONAL$ ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY ❑ PRO LOC JECT PRODUCTS-COMP/OP AGG $ 2,000,000 $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMB Ea accident)$ 1,000,000 BODILY INJURY (Per person) $ B ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS BAP0269863 01 1/20/2016 1/20/2017 BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ NON OWNED HIRED AUTOS AUTOS Underinsured motorist $ 1,000,000 UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DIED I I RETENTION $ WORKERS COMPENSATION PER OTH- I AND EMPLOYERS' LIABILITY YIN STATUTE ER E.L. EACH ACCIDENT $ ANY PROPRIETOR/PARTNER/EXECUTIVE I OFFICER/MEMBER EXCLUDED? N I A E.L. DISEASE - EA EMPLOYE $ (Mandatory in NH) I(yS describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ B Leased 6 Rented Equip CPP026958001 1/20/2016 1/20/2017 $45,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached H more space Is required) 19702246134@myfax.com City of Fort Collins P O Box 580 Fort Colliins, CO 80526 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 Rochelle Romero/MS ACORD 25 (2014101) I NRlYJF nn+em1 ©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 YY) 02/09/2016 PRODUCER Pinnacol Assurance THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY 7501 E Lowry Blvd AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS Denver, CO 80230-7006 CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE NAIC# INSURED Calvin Turner Roofing LLC 3128 West 12th St. INSURER A: PlnnacolAssurance 41190 INSURER B INSURER C: Pueblo, CO 81003 INSURER D: NSURER 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 MMIOD/YYYY DATE(MMIDDNYYY) LIMITS GENERAL LW BIUTY EACH OCCURRENCE DAMAGE TO RENTED COMMERCIAL GENERAL LIABILITY CLAIMS MADE OCCUR PREMISES MED EXP An one rsan PERSONALSADV INJURY GEN'L AGGREGATE IT APPLIERS PER: GENERAL AGGREGATE PRODUCTS -COMPIOP AGO POLICY PRLIMOJECT LOC AUTOMOBILE UABILRY COMBINED SINGLE LIMIT ANY AUTO (Ea AcdtleN) BODILY INJURY r ALL OWNED AUTOS SCHEDULED AUTOS (Per mn 8001LV INJURY HIRED AUTOS NON -OWNED AUTOS (Per accNenl PROPERTY DAMAGE (Pera¢benl) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT OTHER THAN EA ACC ANY AUTO AUTO ONLY: _ AG EXCESSIUMBRELLA LIABILRY OCCUR CLAIMSMADE EACH OCCURRENCE AGGREGATE DEDUCTIBLE RETENTION S WORKERS COMPENSATION AND WC STATU- OTHER Ll A EMPLOYER'S MBIDTY ANY PROPRIETORIPARTNER/EXECUTNE 4128974 02/01/2016 02/01/2017 LIMITS lEACH El EACH ACCIDENT $1,000,000 OFFICER/MEMBER EXCLUDED? E.L DISEASE - EA EMPLOYEE $1,000,0GO It yes, pease tleaCrlee antler SPECIAL PROVISIONS Etlow El DISEASE -POLICY LIMIT 1I.Q00.000 OTHER DESCRIPTION OF OPERATIONSILOCATIONS/VEHICLESIEXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION 1677105 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE CITY OF FORT COLLINS THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO P O BOX 580 NOTIFY 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO FORT COLLIINS, CO 80526 - 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 Angela Folio ACORD 25(2001108) Underwriter ACORD CORPORATION 1988