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Home My WebLink AboutBLUSKY RESTORATION CONTRACTORS INC - INSURANCE CERTIFICATE (4)® A DATE (MMIDDIYYYY) CERTIFICATE OF LIABILITY INSURANCE 4/30/2018 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 Jade Spaeth Arthur J. Gallagher Risk Management Services, Inc. NAMEP rvE . 303-889-2558 WC 6300 South Syracuse Way, Suite 700 E-MAIL Centennial CO 80111 . jade_spaeth@ajg.com INSURER(S) AFFORDING COVERAGE NAIC k INSURED Blusky Restoration Contractors, Inc. 9767 E. Easter Ave. Centennial, CO 80112 __ INSURER A:TOkio Marine Specialty Ins CO 23850 INSURER B . Libeqy Mutual Fire Insurance Company 23035 INSURER C: PhiladelDhia Indemnitv Insurance Company 18058 rn1/FDARF¢ CFDTIGICATG NIIMRFD• 12n2993279 DF\/ICI0PJ NIIMRFP- 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 INSD SUB I WVD I POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP Wt)DNYYY LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE X❑ OCCUR PPK1644970 5/1/2017 6/1/2018 EACH OCCURRENCE $1,000,000 Li PREMISES Eaoccurrence $100,000 MED EXP (Any one person) $5,000 PERSONAL & ADV INJURY $1,000,000 GENT AGGREGATE LIMIT APPLIES PER: POLICY JECOT- LOC OTHER: GENERALAGGREGATE $2,000,000 PRODUCTS - COMP/OP AGG $2,000,000 $ C AUTOMOBILE LIABILITY X ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED X AUTOS ONLY X AUTOS ONLY PHPK1645310 5/1/2017 6/1/2018 Co accident $1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ AMAGE Per accident $ Comp/Coll Deductible $1,000 A X UMBRELLA LIAB EXCESS LIAR X OCCUR CLAIMS -MADE PUB581572 5/1/2017 6/1/2018 EACH OCCURRENCE $10,000,000 X AGGREGATE $10,000,000 DED RETENTION $ $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y /N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? ❑N (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N/A WC2-Z91-462479-018 5/1/2018 5/1/2019 X I STER I ATUTE I ERH E.L. EACH ACCIDENT $1,000,000 E.L. DISEASE - EA EMPLOYEE $1,000,000 E.L. DISEASE - POLICY LIMIT $1,000,000 1 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. !`CDTIFICATF 41r11 rl['D CANCFI 1 ATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Ft. Collins THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 215 N. Mason Street ACCORDANCE WITH THE POLICY PROVISIONS. Ft. Collins CO 80537 AUTHORIZED REPRESENTATIVE 1988-Z015 ACORD CUHPUKA I IUN. All rights reserved. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD