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HomeMy WebLinkAbout262877 RTN ROOFING SYSTEMS - INSURANCE CERTIFICATE (3)ACORN® C" CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 3/26/2018 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 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 y NAME: Renee McReynolds Ewing -Leavitt Insurance Agency, Inc. PHONE (970) 679-7344 FAX (866)425-6180 A/C No ADDRESS:renee-mcreynolds@leavitt.com 4090 Clydesdale Parkway INSURERS AFFORDING COVERAGE NAIC # Suite 101 INSURERA:United Fire & Casualty 13021 Loveland CO 80538 INSURED INSURERB:Pinnacol Assurance 41190 INSURER C: RTN Roofing Systems LLC INSURERD: 5854 Lockheed Ave INSURER E : INSURERF: Loveland CO 80538 COVERAGES CERTIFICATE NUMBER:18-19 REVISION NUMBER: THIS !S 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. INTSRR TYPE OF INSURANCE JAM ADDLSU n POLICY NUMBER POLICY EFF POLICY EXP LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A CLAIMS -MADE OCCUR DAMAGE TO RENTED R MISEa occurrence $ 500,000 x MEDEXP (Any one person $ 10,000 Blkt Addl Insureds 60488595 4/l/2018 4/l/2019 x Blkt Waiver of Subrog PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY [X]PRO JECT ❑ LOC incl Jobsite Pollution PRODUCTS - COMP/OPAGG $ 2,000,000 $ OTHER: $100,000 limit AUTOMOBILE LIABILITY COEaMBINED ccident SINGLE LIMIT $ 1,000,000 X BODILY INJURY (Per person) $ A ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS 60488595 4/1/2018 4/1/2019 BODILY INJURY (Per accident) $ X PROPERTYa accident) P NON -OWNED HIRED AUTOS AUTOS X $ Blkt WOS x Blkt Add[ Insureds X UMBRELLA LAB X OCCUR EACH OCCURRENCE $ 1,000,000 AGGREGATE $ 1,000,000 A EXCESS LIAB CLAIMS -MADE DED RETENTION $ 60486595 4/l/2018 4/1/2019 B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE EXCLUDED? (Mandatory ( ry in NH) NIA incl Blanket Waiver of Subrogation 4054406 4/1/2018 4/1/2019 X PER OTH- STATUTE ER E.L. EACH ACCIDENT $ 500,000 E.L. DISEASE - EA EMPLOYE $ 500,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT 1 $ 500,000 A Contractors' Equipment 60488595 4/l/2018 4/l/2019 Installation Floater $50,000 Limit DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION City of Fort Collins 700 Wood Street Fort Collins, CO 80521 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 R McReynolds/RESTEI em ACORD 25 (2014/01) Iklign7s, r)nlnna� ©1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD