HomeMy WebLinkAboutMCDAVID CONSTRUCTION INC - INSURANCE CERTIFICATE (5)ACORD CERTIFICATE OF LIABILITY INSURANCE
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DATE (MMIDDlYYYY)
12/22/2015
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(les) must be endorsed. If SUBROGATION IS WAIVED, subject to
the terns 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
LeBaron & Carroll, LLC
1350 E. Southern Avenue
Mesa AZ 85204
CONTACT
NAME: Janice Volpe, CIC, CISR
PHONE (480) 834-9315 X (480)844-9866
AIC No Ex AIC No
E-MAIL ADDRESS: e
ADDRESS: @landc. com
INSURER(S) AFFORDING COVERAGE
NAICi
INSURERA De ositors Insurance Company
42587
INSURED
McDavid Construction, Inc.
2239 E. Rose Garden Loop
Phoenix AZ 85204
INSURERB AMCO Insurance Company
19100
INSURERCNationwide Mutual Insurance Company
23787
INSURER D:Co erPoint General Insurance Co.
13043
INSURERS:
1 INSURERF:
COVERAGES CERTIFICATE NUMBER:2015/2016 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 WffH 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
INSD
WVD
POLICY NUMBER
POLICY EFF
MMIDD/Y
POLICY EXP
MMIDDIYYYY
LIMITS
A
X
I COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE FX OCCUR
ACP3016959762
12/18/2015
12/10/2016
EACH OCCURRENCE
$ 1,000,000
PREMISES Ea occurrence
$ 100,000
MED EXP (Any one person)
$ 5,000
PERSONAL BADVINJURY
$ 1,000,0o0
GEN'L AGGREGATE LIMIT APPLIES PER:
POLICY JERCT LOC
OTHER
GENERAL AGGREGATE
$ 2,000,000
PRODUCTS - COMP/OPAGG
$ 2,000,000
$
B
AUTOMOBILE LIABILITY
ANY AUTO
ALL OWNED SCHEDULED
AUTOS AUTOS
NON -OWNED
1HIREDAUTOS AUTOS
ACP3016959762
12/18/2015
12/18/2016
UM-MdeM GL LIMI
CE,X
$ 1,000,000
BODILY INJURY (Per person)
$
BODILY INJURY (Per accident)
$
PROPERTY DAMAGE
Per accident
$
B
X
UMBRELLA LIAB
EXCESS LIAB
X
OCCUR
CLAIMS -MADE
ACP3016959762
12/18/2015
12/19/2016
EACH OCCURRENCE
$ 21000,000
AGGREGATE
$ 21000,000
DED RETENTION$
D
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY YIN
ANY PROPRIEWRIPARTNER/EXECUTIVE
OFFICERMEMBER EXCLUDED?
(Mandatory In NH)
If yyees, describe under
DESCRIPTION OF Of ERAIIONS below
NIA
1017576
9/1/2015
9/1/2016
PER$
X STATUTE ERH
E. L. EACH ACCIDENT
$ 1,000,000
E.L DISEASE - EA EMPLOYEE
$ 1,000,000
GL. DISEASE- POLICY LIMIT
$ 1 000 OCO
C
Leased/Rented Equipment
ACP3016959762
12/18/2015
12/18/2016
Limit $50,000
DESCRIPTION OF OPERATIONS 1 LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached it more space Is required)
!`CAT7CIf ATC wni r1GR CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
City of Fort Collins
PO Box 580
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
Fort Collins, CO 80526
AUTHORIZED REPRESENTATIVE
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S Perkinson/JANICE
ACORD 25 (2014/01)
INS025 (201401)
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