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HomeMy WebLinkAboutWEATHERSURE SYSTEMS INC - INSURANCE CERTIFICATEClient#: 1091376 WEATHSYS ACORDr. CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD.YYYY) 1 6/30/2017 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 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 USI Colorado, LLC Construction P.O. Box 7050 NAME: Client Manager PHONEo FAX ANExt :g00 873-8500 A/C, No): 303-831-5295 E-MAIL den.contractors@usi.com Englewood, CO 80155 800 873-8500 INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: Valley Forge Insurance Company 20508 INSURED INSURER B : Pinnacol Assurance Company 41190 WeatherSure Systems, Inc. 2401 S. Delaware Street — — - INSURER C : - Denver, CO 80223 INSURERD: INSURER E : INSURER F : 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 CONTRACTOR 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 LTR TYPE OF INSURANCE IADDLSUBRi INSR 'WVD-_ POLICY NUMBER PMT6013803141 POLICY EFF (MM/DD/YY 7/01/2017 POLICY EXP MM/DD/YYYY LIMITS $1 000000 $100 OOO A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE � OCCUR PD Ded:10,000 07/01/2018 EACH XI GOCCURRENCE PREMISES ERENTED rrnce MED EXP (Any one person) $15 000 PERSONAL & ADV INJURY $1,000,000 s2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: X; POLICY JECOT [I LOC OTHER: GENERAL AGGREGATE PRODUCTS - COMP/OP AGG _ $2,000,000 $ A AUTOMOBH_ELIABILm X ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS X HIRED AUTOS X NON -OWNED AUTOS X IDrive Oth Car BUA6049523751 7/01/2017 07/01/201(CEOaccid.ntSINGLELIMIT 1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ $ PROPERTY DAMAGE Per accident $ A X UMBRELLA LIAB EXCESS LIAR X I OCCUR CLAIMS -MADE CUE6049523765 0710112017 0710112018 EACH OCCURRENCE s6,000,000 s6,000,000 AGGREGATE DED I X RETENTION $1 O 000 $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y / N OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N/A 3471401 7/01 /2017 07/01 /201 X PER OTH- E.L. EACH ACCIDENT $1 000 000 E.L. DISEASE - EA EMPLOYEE $1 000 000 E.L. DISEASE - POLICY LIMB I $1 000,000 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Re: Roof and Waterproofing Services City of Fort Collins Purchasing Division 256 West Mountain Avenue Fort Collins, CO 80521 L,A110.1CLLH I IVIV 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 ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) 1 of 1 #S20947030/M20939915 The ACORD name and logo are registered marks of ACORD SRNZP