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HomeMy WebLinkAboutROCKY MOUNTAIN STONE & CONCRETE FLATWORK LLC - INSURANCE CERTIFICATE (4)��•� ROC KM-3 ACORO DATE (MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 07/06/2017 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 970-356-8030 CONTACT Michael J Schmitt CIC Rich & Cartmill Ins of CO PHONE FAX of Colorado LLC (A/C, No, Ext) 870_356-8030 FAX NoZ870-356-8032 8213 W. 20th Street MAIL Greeley, CO 80634 DDRE� Michael J Schmitt CIC __ INSURER S AFFORDING COVERAGE NAIC # ._ INSURED Rocky Mountain Stone & Concrete Flatwork, LLC 1804 SW 10th Loveland, CO 80537 INSURER A: United Fire Group ,u�„ono .. Pinnacol Assurance INSURER F : !1A1/CO A!_CC !"COT(CI!`ATF All "92C:D• RF\/IClr)Al All 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, _EXCLU_SIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXPLTRT LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE [X] OCCUR AGGREGATE LIMIT APPLIES PER: PRo- � POLICY ❑ JECT LOC OTHER X 60435436 07/26/2017 07/26/2018 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED REMISES fEaMED $ 100,000 EXP (Any oneperson) 5,000 PERSONAL & ADV INJURY 1,000,000 EN'L GENERAL AGGREGATE 2,000,000 X PRODUCTS - C MP/OP AGG 2,000,000 $ AUTOMOBILE LIABILITY ANY AUTO OWNED SCHEDULED AUTOS ONLY LAUTOS HIRED NON -OWNED AUTOS ONLY AUTOS ONLY COMBINED SINGLE LIMIT IE�ac4ldent) ._. _ BODILY INJURY Perperson) BODILY INJURY jPer accident PROPERTY AMAGE Peraccident�____ $ _______ UMBRELLA LIAB EXCESS LIAB OCCUR EACH OCCURRENCE HCLAIMS-MADE AGGREGATE DED RETENTION $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ( OFFICER/ME MBEER/EXCLUDED?ECUTIVE (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS beiow N/A 41666" 08/01/2017 08/01/2018 X PERFUTE OTH- E.L. EACH ACCIDENT 500,000 $ E.L. DISEASE - EA EMPLOYEE 500,000 DISEASE - P LICY LIMIT 500 D00 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) The City of Fort Collins is listed as additional insured as pertains to the General Liabiity policy, per written contract. CIT-FOR 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 AUTHORIZED REPRESENTATIVE Michael J Schmitt CIC ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD