Loading...
HomeMy WebLinkAboutCENTEX LLC - INSURANCE CERTIFICATE (4)i-� CENTE-4 OP ID: KLJ ACORO CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY) 44� 1 07/10/2017 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 have ADDITIONAL INSURED provisions or 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 970-674-8825 CONTACT Scott P. Runyan Renaissance Insurance Group PHONE FAX P O Box 478 (A/C, No, Ext): 970-674-8825 (A/C, No).970-674-8826 101 E Main Street EDpAIL srunyan renmsurance.com Windsor, CO 80550 Scott P. Runyan INSURERS AFFORDING COVERAGE NAIL INSURER A: Artisan & Truckers Casualty Co INSURED Centex, LLC INSURER B:PInnacol Assurance 41190 Andrew Beers - - -- 5137 NW Frontage Road INSURERC: Fort Collins, CO 80524 INSURER D: INSURER E : INSURER F : /`(1VCRAt:FC rF=PTIFICATF NI IMRFR• RFVICIr1N NI IMRFR• 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 DDL UBR POLICY NUMBER POLICY EFF POLICY EXPLTR LIMITS A X I COMMERCIAL GENERAL LIABILITY CLAIMS -MADE X OCCUR X 03934472 09/27/2016 09/27/2017 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED E occurrence PREMI(Ea 100,000 $ GEN'L X MED EXP (Any oneperson) $ 5,000 PERSONAL & ADV I NJ URY $ 1,000,000 AGGREGATE LIMIT APPLIES PER: POLICY LJ jea- LOC OTHER GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP/OP AGG $ 2,000,000 A AUTOMOBILE LIABILITY ANY AUTO OWNED SCHEDULED AUTOS ONLY X AUTOS SSWN AUTOS ONLY A�TOS ONLY X 03934472 09/27/2016 09/27/2017 COMBINED SINGLE LIMIT Ea accident 1,000,000 $ BODILY INJURY Perperson) $ BODILY INJURY Per accident $ PeroaceltlentDAMAGE $ UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DED T RETENTION $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE YIN QgFER EXCLUDED? (nAanFICER/MEMBdatory in NH) f yes, describe under DESCRIPTION OF OPERATIONS below NIA 4203090 07/07/2017 07/01/2018 STRT T ORH- E. L. EACH ACCIDENT 1,000,000 $ E.L. DISEASE - EA EMPLOYEE 1,000,000 E.L. DISEASE- POLICY LIMIT 1,000,000 A 'Motor Truck Cargo �_. 03934472 09/27/2016 09/27/2017 Limit Deduct 100,000 1,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space Is required) FAX 224-6134 Sub'ect to policy forms conditions, definitions and exclusions Certificate holder is included as additional insured with respect to General Liability and Auto Liability when required by written contract. !11=M'r1C1 `ATC Uf'%l IICO f ANP`CI 1 ATInKI CITYOFF SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Fort Collins ACCORDANCE WITH THE POLICY PROVISIONS. PO Box 580 Fort Collins, CO 80522-0580 AUTHORIZED REPRESENTATIVE Q r7Ctcte�Jira a�x cL ,Leap ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD