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HomeMy WebLinkAboutRETAIL CONSTRUCTION SERVICES INC - INSURANCE CERTIFICATEACOOR "® CERTIFICATE OF LIABILITY INSURANCE page 1 of 1 FDATE 12/(14/2015 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 Willis of Minnesota, Inc. c/o 26 Century Blvd. P. O. Box 305191 Nashville, TN 37230-5191 CONTACT NAME: PHONE FAX N XT: 877-945-7378 NO): 888-467-2378 A DARESS: cert:ificat:es@willis.com INSURER(S)AFFORDING COVERAGE NAIC # INSURERA:Zurich American Insurance Company 16535-000 INSURED Retail Construction Services, Inc. INSURER B: Liberty Insurance Underwriters Inc 19917-000 INSURERC: 11343 39th St N Lake Elmo, MN 55042 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 23974768 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 TYPE OF INSURANCE DDL SUBFf POLICY NUMBER POLICY EFF(MWDDNYYY POLICY EXPLTR LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE X OCCUR GL 0082548-01 12/31/201 12/31/201( EACH OCCURRENCE $ 11000,000 RAWRETT gqENTED aoccurence) $ 500,000 MED EXP (Anyone person) $ 15 000 PERSONAL& ADV INJURY $ 11000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY JET � LOC OTHER: GENERAL AGGREGATE $ 2,000,000 PRODUCTS-COMP/OPAGG $ 2,000,000 $ A AUTOMOBILE LIABILITY X ANY AUTO ALLOWNED ISCHEDULED AUTOS AUTOS X HIRED AUTOS X NON -OWNED AUTOS BAP 0082547-01 12/31/201 12/31/2016 COMBINEDSINGLELIMIT (Ea accident) 1 000, OOO $ r BODILY INJURY(Per person) $ BODILY INJURY(Per accident) $ PROPERTY DAMAGE Per accident) $ B UMBRELLALIAB LIAB Xd OCCUR CLAIMS -MADE 1000021115-06 12/31/201 12/31/201 EACHOCCURRENCE $ 10, 000, 000 X4EXCESS AGGREGATE $ 10, 000, 000 DED RETENTION $ $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y® OFFICER/MEMBER EXCLUDED? (Mandatory in NH) t yes, describe under DESCRIPTION OF OPERATIONS below N/A WC 0082549-01 12/31/201 12/31/201 X PERSTATUTE H - ER E.L. EACH ACCIDENT $ 1, 000, OOO E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE -POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS/ VEHICLES (ACORD 101, Additonal Remarks Schedule, may be attached if more space is required) For Permit and License Purposes CERTIFICATE HOLDER CANCELLATION 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 City of Ft. Collins 281 N College Ave. Ft. Collins, CO 80522 Coll:4817899 To1:2015126 Cert:Mt174768©19884014ACORD CORPORATION. All riahtsreserved ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD