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HomeMy WebLinkAboutASPEN CONSTRUCTION - INSURANCE CERTIFICATE (3)® CERTIFICATE OF LIABILITY INSURANCE DATE 4/25/20181 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 Madison Insurance Group South Cherry St, Ste 900 Denver CO 80246 UUNIALA NAME: Paula Blohm PHONE, NN Ext : 3033220800 (A/C, No): 3033220874 JA/600 ADDRESS: pblohm@madisoninsurance.net INSURER(S) AFFORDING COVERAGE NAIC # INSURER A : PINNACOL ASSURANCE 41190 INSURED Aspen Construction 204 N. Link Lane #3 Fort Collins CO 80524 INSURER B : AUTO OWNERS INSURANCE INSURER C : SECURITY NATIONAL INSURANCE COMPANY INSURER D : NATIONAL UNION FIRE INSURANCE COMPANY 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 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. LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER (MM/DD/YYYY) (MM/DD/YYYY) LIMITS C X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE F_x] OCCUR NA154653500 04/29/2018 04/29/2019 EACH OCCURRENCE $ 1,000,000 PREMISES (Ea occurrence) s 100,000 MED EXP (Any one person) s 5,000 PERSONAL & ADV INJURY $ 1,000,000 MGEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO- JECT LOC OTHER. GENERAL AGGREGATE $ 2,000,000 PRODUCTS -COMP/OP AGG $ 2,000,000 $ B AUTOMOBILE LIABILITY X ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED x AUTOS ONLY x AUTOS ONLY 50-675-828-00 04/28/2018 04/29/2019 (Ea accident) $ 1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ (Per accident) $ D UMBRELLA LIAB EXCESS LIAB �( OCCUR CLAIMS -MADE QEXR4593816 04/29/2018 04/20/2019 EACH OCCURRENCE $ 1,000,000 x AGGREGATE $ 1,000,000 DED I I RETENTION $ $ A ORKERS COMPENSATION ND EMPLOYERS' LIABILITY NY PROPRIETOR/PARTNER/EXECUTIVE YIN FFICER/MEMBER EXCLUDED? Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N / A 3018240 06/01/2017 06/01/2018 X STATUTE ER E.L. EACH ACCIDENT $ 500,000 E.L. DISEASE - EA EMPLOYEE $ 500,000 E.L. DISEASE - POLICY LIMIT s 500,000 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Fort Collins Utilities ACCORDANCE WITH THE POLICY PROVISIONS. PO Box 580 AUTHORIZED REPRESENTATIVE Fort Collins, CO 80522 pa,•.ia, 131[41� ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD