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BLUSKY RESTORATION CONTRACTORS INC - INSURANCE CERTIFICATE (3)
ACC?RO® CERTIFICATE OF LIABILITY INSURANCE 75131/2018 (MM/DDYYYY) 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). Fenotennuia CER CONNAME: Jade S aeth r JGallagher Risk Management Services, Inc. PHONEFAxSoth Syracuse Way, Suite 700 No. EA: 303-889-2558 Arc, NoE-MAILpjl CO 80111 ADDRESS: Jade s aeth a' .com INSURED Blusky Restoration Contractors, Inc. 9767 E. Easter Ave. Centennial, CO 80112 INSURER(S) AFFORDING COS INSURER A: Tokio Marine Specialty Ins Co INSURER B : Liberty Mutual Fire Insurance INSURER D ERF: rnvFRAr.FS rFRTIFICATF NI IMRFR• 19513n3Qnd RFVISInN NUMRFR: 23850 23035 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. ILTRR TYPE OF INSURANCE LT I L POLICY NUMBER MM/DDNYYSU8117— POLICY F MM/DD/YY POLICY P LIMITS A X COMMERCIAL GENERAL LIABILITY - -- CLAIMS -MADE aOCCUR PPK1828149 8/1/2018 5/1/2019 EACH OCCURRENCE $1,000,0D0 — �0 ZEcua PREMISES Ea occurrence) $100,000 MED EXP (Any one person) $ 5,OW PERSONAL & ADV INJURY $1,000,000 GENT AGGREGATE LIMIT APPLIES PER: X PRO - POLICY JECT LOC OTHER: GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP/OP AGG $ 2,000.000 $ C I AUTOMOBILE LIABILITY X ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS X HIRED X NON -OWNED AUTOS ONLY AUTOS ONLY PHPK1827622 6/1r2018 511/2019 COMBINED SINGLE LIMIT Ea accident $'1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ Comp/Coll Deductible $1,000 A X UMBRELLA LIAR EXCESS LIAB X OCCUR CLAIMS -MADE PUB631346 6/1/2018 5/1/2019 EACH OCCURRENCE $10,000,000 X AGGREGATE $10,0D0,000 DED f RETENTION $ $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANYPROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N / A WC2-Z91-462479-018 511/2018 5/1/2019 X STATUTE EORH E.L. EACH ACCIDENT $1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE - POLICY LIMIT $1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) BluSky Restoration Contractors, Inc. certifies that liability insurance in the amount of $1,000,000 that indemnifies the City against any and all loses that may arise from the use of the parking spaces per contract stipulations. CERTIFICATE HOLDER CANCELLATION City of Ft. Collins 215 N. Mason Street Ft. Collins CO 80537 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. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD