Loading...
HomeMy WebLinkAboutMB ROOFING INC - INSURANCE CERTIFICATE (3)MBROO-2 OP ID: E1 AC�ORO CERTIFICATE OF LIABILITY INSURANCE ATE (MM/DD/YYYY) r02/29/2016 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 endorsement(s). PRODUCER Brown & Brown of Colorado, Inc 2170 S. Parker Rd Ste 251 Denver, CO80231 rt Jason Sartor CONTNAME: Evie Jo Ontiveros AJC, No, Eli: 720-963-4286 FAX No): 720-962-5142 SS: eontiveros@bbdenver.com ADDRESS, INSURERS AFFORDING COVERAGE NAIC # INSURER A:Secura Insurance Co. 22543 INSURED MB Roofing, Inc. Mark & Terry Brady PO Box 1289 Commerce City, CO 80022 INSURERS: Pinnacol Assurance Company 41190 INSURER C: NATIONAL UNION FIRE INS. CO. 19445 INSURER 0: Knight Specialty Ins Company 15366 INSURER E : Rockhill Insurance Co 28053 INSURER F : COVERAGES CERTIFICATE NUMBER: 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 LTR TYPE OF INSURANCE ADDL N SUBR POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DD/YYYY LIMITS D X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE 1XI OCCUR X KSVENA160045001 03/01/2016 03/01/2017 DAMAGET RENTED PREMISES Ea occurrence $ 50,00 MED EXP (Any one person) $ 5,00 X Empl Benefits PERSONAL & ADV INJURY $ 1,000,00 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,00 POLICY PRO JECT ❑ LOC PRODUCTS - COMP/OP AGG $ 2,000,00 Emp Ben. $ 1,000,00 OTHER AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ 1,000,00 X BODILY INJURY (Per person) $ A ANY AUTO A3174667 03/01/2016 03/01/2017 ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ NON -OWNED HIRED AUTOS AUTOS PROPERTY DAMAGE Per accident $ UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 1,000,00 X AGGREGATE $ 1,000,00 C EXCESS LIAB CLAIMS MADE EBU062115793 03/01/2016 03/01/2017 DED I X I RETENTION $ 0 $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETORIPARTNER/EXECUTIVE Yf" OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS belo, N f A 4027282 03/01/2016 03/01/2017 X PER OTH- STATUTE ER E.L. EACH ACCIDENT $ 1,000,00 E.L. DISEASE - EA EMPLOYEE $ 1,000,00 EL DISEASE POLICY LIMIT $ 1,000,00 A Lease/Rent Eq CP3174666 03/01/2016 03/01/2017 Lease/Ren 100,00 E Pollution Liab ENVP007803-02 03/01/2016 03/01/2017 Poll Liab 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Per policy terms, conditions and exclusions. City of Fort Collins is an additional Insured for General Liability as required by written contract. 4-Cm I IYIi A I C r1VLUCR FTCOLLC City of Fort Collins PO Box 580 Ft Collins, 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 © 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD