HomeMy WebLinkAbout157655 WATTLE & DAUB CONTRACTORS INC - INSURANCE CERTIFICATE (7)ACC>R" CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DDlYYYY)
1/20/2016
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 CCOOMNT CT Laura Maes
Denver Agency PHONE (303) 892-6900 FAX
AIC No):
210 University Blvd, Suite 600 E-MAIL laura@denvera en com
ADDRESS: 9 Ly
Denver CO 80206-4661
INSURED
Wattle & Daub Contractors, Inc.
8 Gibbs Rd.
NAIC #
Cc
:Phoenix Insurance Co 125623
D:
Laramie WY 82070 INSURER F
r_r)VFRAr;F_R CI=RTICIrATC KII IIUID11=0.9n1 C r_. /AT /n70
As
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 ADD L SUBR POLICY EFF POLICY EXP
LTR TYPE OF INSURANCE POLICY NUMBER M MM/DDNYYYI LIMITS
A
X
COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE ❑X OCCUR
EACH OCCURRENCE
DAMAGE TO RENTED
PREMISES Ea occurrence
$ 1,000,000
$ 50,000
MED EXP (Any one person)
$ 5,000
VCGP050191
1/1/2016
1/1/2017
PERSONAL & ADV INJURY
$ 1,000,000
GENT
AGGREGATE LIMIT APPLIES PER:
[X] PRO-
GENERAL AGGREGATE
$ 2,000,000
PRODUCTS -COMP/OPAGG
$ 2,000,000
POLICY JECT LOC
Employee Benefits
$ 1,000,000
OTHER:
AUTOMOBILE
LIABILITY
ANY AUTO
ALL OS SCHEDULED
AUTOS AUTOS
BA-1281YO79-16-SEL
1/1/2016
1/1/2017
Ee aBINED SINGLE LIMIT
ccidenB
$ 1,000,000
X
BODILY INJURY (Per person)
$
BODILY INJURY Per accident
( )
$
NON -OWNED
HIRED AUTOS Ix AUTOS
X
PROPERTY DAMAGE
Per accident
$
Uninsured motorist combined
$ 1,000,000
UMBRELLA LIAR
IOCCUR
EACH OCCURRENCE
$
AGGREGATE
$
EXCESS LIAB
CLAIMS -MADE
DIEDRETENTION $
$
C
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY YIN
ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICER/MEMBER EXCLUDED?
(Mandatory in NH) ❑
If yes, describe under
DESCRIPTION OF OPERATIONS below
NIA
4093011
1/1/2016
1/1/2017
I PER I _
X STATUTE I I OR
E.L. EACH ACCIDENT
$ 1 OOO OOO
E.L. DISEASE - EA EMPLOYE
$ 1,000,000
E.L. DISEASE - POLICY LIMIT
$ 1 000 000
7!
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
Certificate Holder is included as Additional Insured regarding General Liability.
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
City of Fort Collins THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
P.O. Box 580 ACCORDANCE WITH THE POLICY PROVISIONS.
Fort Collins, CO 80524
AUTHORIZED REPRESENTATIVE
C McKeever, CIC/LAURA
U 1988-2014 ACORD CORPORATION. All rights reserved.
ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD
INCn9S,o Anil