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HomeMy WebLinkAboutCOLORADO MILLWORK AND TRIM - INSURANCE CERTIFICATE,AcoR" CERTIFICATE OF LIABILITY INSURANCE DATE(MM1DD/YYYY) 6.� 1 06/27/2017 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 CONTACT NAME: AP INTEGO INSURANCE GROUP PHONE FAX 375 Woodcliff Drive A/C,�No Exec.(ac No): IL Suite 103 ADDRESS: Fairport, NY 14450 _ INSURER(S) AFFORDING COVERAGE NAIC# INSURER A: INSURED David Hollerbach Colorado Millwork and Trim P.O. Box 865 LaPorte, CO 80535 I INSURER C : INSURER E : NorGUARD Insurance Company 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 TYPE OF INSURANCE ADDL SUER POLICY EFF POLICY EXP LIMITS LTR POLICYNUMBER MMIDD/YYW MMIDDIYYYY COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 0 CLAIMS -MADE OCCUR _ _ $ 0 DAMAGE TO RENTED PREMISES Ea occurrence MED EXP (Any one person) $ 0 PERSONAL & ADV INJURY $ 0 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 0 POLICY jEC7 LOC PRODUCTS -COMP/OP AGG $ 0 $ OTHER. AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ BODILY INJURY (Per person) ANY AUTO $ OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED AUTOS ONLY AUTOS ONLY $ _ $ BODILY INJURY (Per accident) PROPERTY DAMAGE Per accident UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE EXCESS LIAR CLAIMS -MADE $ DIED RETENTION $ $ COMPENSATION AND EMPLOYERS' LIABILITY I N ANYPROPRI ETORIPARTN ER/EXECUTIVE YIN— B OFFICER/MEMBEREXCLUDED? a NIA DAWC857570 04/27/2017 04/27/2018 X SEATUTE ERH -- $ 100,000 _ E.L. EACH ACCIDENT E.L. DISEASE - EA EMPLOYEE (Mandatory in NH) $ 100,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS 1 LOCATIONS 1 VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Exclusions: David Hollerbach; CERTIFICATE HOLDER CANCELLATION The City of Fort Collins PO BOX 580 Fort Collins, CO 80522 ACORD 25 (2016/03) 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 ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD