HomeMy WebLinkAboutHOMETOWN HEATING & AIR INC DBA WELZIG MECHANICAL - INSURANCE CERTIFICATE (5)M/DDIYYYY)
(M
A L7 CERTIFICATE OF LIABILITY INSURANCE Sr 212017 DATE ATE(M
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 endorsements .
PRODUCER CONTACT
NAME: _ Pat Deaver
rth CompaniesL.C. _
TrueNo, PHONE FAX
275 S Main Ste 100 _(AIC, No, E.0; 303-774-2954 Z N,): 303-776-5495
E-MAIL deaver@truenorthcom anies.com
Lonamont CO 80501 ADDxcsS�P P -__
INSURED HOMEHEA-02
Hometown Heating & Air, Inc dba Welzig Mechanical,
1831 Boston Avenue, # D
Longmont CO 80501
INSURERA:Owners Insurance Company 132700
INSURER B : Pinnacol Assurance Company 141190
INSURER D :
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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
LTR
TYPE OF INSURANCE
I D
WV
POLICY NUMBER
POLICY EFF
MMIDONY
POLICY EXP
MWDDIYYYY
LIMITS
A
X
COMMERCIAL GENERAL LIABILITY
❑X OCCUR
74432747
8/9/2017
8/9/201 B
EACH OCCURRENCE
E1,000,000
DAMAGECLAIMS-MADE
PREMISES (Eat renRENTEncce)
$300,000
MED EXP (Any one person)
$10,000
PERSONAL & ADV INJURY
$1,000,000
GEN'L
AGGREGATE LIMIT APPLIES PER:
POLICY a JECOT- 7 LOC
OTHER:
GENERAL AGGREGATE
E2,000,000
PRODUCTS - COMP/OP AGG
$2,000,000
E
A
AUTOMOBILE LIABILITY
X ANY AUTO
OWNED SCHEDULED
AUTOS ONLY AUTOS
HIRED NON -OWNED
X AUTOS ONLY X AUTOS ONLY
5043274700
8/9/2017
8/9/2018
Ea accident
E1,000,000
BODILY INJURY (Per person)
E
BODILY INJURY (Per accident)
E
AMAGE
Per accident
E
E
UMBRELLA LIAB
EXCESS LIAB
OCCUR
CLAIMS -MADE
EACH OCCURRENCE
E
AGGREGATE
E
DED RETENTION E
E
B
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY
ANY PROPRIETOR/PARTNER/EXECUTIVE YIN
OFFICER/MEMBER EXCLUDED?
(Mandatory in NH)
If es, describe under
DESCRIPTION OF OPERATIONS below
NIA
4141577
8/112017
8/1/2018
X STATUTE ER
E.L. EACH ACCIDENT
$500,000
E.L. DISEASE - EA EMPLOYE
$500,000
E.L. DISEASE - POLICY LIMIT
1 $500,000
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space IsrKpIlrod)
rCDTIGIr'ATC IJ111 1117D r.A111r-FI I ATInIY
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
City of Fort Collins
PO Box 580
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
Fort Collins CO 80526
USA
AUTHORIZED REPRE ENTATIVE
7
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V 1988-ZU15 AGUKU t;UKNUKA I IUN. All ngnts reserves.
ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD