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HomeMy WebLinkAboutFOOTHILLS GUTTER & INSULATION INC - INSURANCE CERTIFICATE (2)FOOTGUT-01 VMATHIASON ACORN DATE (MM/DD/YYYY) `,,,,� CERTIFICATE OF LIABILITY INSURANCE F12/7/2015 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 CONTACT NAME: PFS Insurance Group PHONE FAX 4848 Thompson Parkway Suite 200 (A/c, No, Exq: (970) 635-9400 (ao,No►:_(970) 635 9401 Johnstown, CO 80534 Ao RESS_valeriem� YP m fsinsurance.com _ _ INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: Employers Mutual Casualty Co INSURED INSURER B : Pinnacol Assurance Co _ _ _ 41190 Foothills Gutter & Insulation Inc INSURER C : Telk Sheet Metal Works Inc dba PO Box 2156 INSURER D Loveland, CO 80539 INSURER E : INSURER F : CnVFRAGFB CFRTIFICATF Nt]MRFR7 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 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 I TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR Ill WVD' POLICY NUMBER MM/DDNYYY MM/DD/Y A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 X 1 5D06555 12/05/2015 ' 12/05/2016 DAMAGERENTED 100,000 CLAIMS -MADE OCCUR PREMISES (Eaoccurrence) ( $ MED EXP (Any one person) $ 5,000 $ 11000,00 PERSONAL & ADV INJURY GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY JECT PRO — J LOC PRODUCTS-COMP/OPAGG _- _-_ $ 2,000,00 $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 A ANY AUTO 5EO6555 12/05/2015 12/05/2016 BODILY INJURY (Per person) $ ALL OWNED SCHEDULED X BODILY INJURY (Per accident) $ AUTOS AUTOS PROPERTY DAMAGE $ X X NON -OWNED HIRED AUTOS AUTOS (Per accident) UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB 1 CLAIMS -MADE DED RETENTION $ $ WORKERS COMPENSATION TH- STATUTE ER AND EMPLOYERS' LIABILITY Y/N $ 1,�0,000 B ANY PROPRIETORlPARTNER/EXECUTIVE PROPRIET n 4173269 2 0 5' 12/01/2016 E.L. EACH ACCIDENT ONY OR EXCLUDED? ( N/A - E.L. DISEASE - EA EMPLOYEE -- $ 1,000,000 U yes, describe under DESCRIPTION OF OPERATIONS below ( E.L. DISEASE -POLICY LIMIT - - _ 1 $ 1,000,00 A Property 5AO6555 12/05/2015 12/05/2016 BPP 25,500 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES ACORD 101, Additional Remarks Schedule, may be attached if more ace is required) 1 Y P All locations/All operations CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Fort Collins Attn: Kaye THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ty y ACCORDANCE WITH THE POLICY PROVISIONS. P.O. Box 580 Fort Collins, CO 80522 AUTHORIZED REPRESENTATIVE © 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD