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HomeMy WebLinkAboutANTLER CONSTRUCTION CO - INSURANCE CERTIFICATE (8)- ANTLE-6 OP ID: KR ,4`coRn CERTIFICATE OF LIABILITY INSURANCE FDAT06/E(27/01MM/2018 Yj 8 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 endorsement(s). PRODUCER Phone:303-202-0082 CAM_ACT Western Group Inc -Denver PHONE — - • FAX — - 6425 West 44th Ave Fax: 303-202-0086 AIC, No, E91 _ (A/C, Nam; PO Box 497 E-MAIL Wheatridge, CO 80034 ADDRESS: Jim Howes INSURER(S) AFFORDING COVERAGE NAIC A INSURED Antler Construction, Co. 546 SE 8th Street,Unit B4 Loveland, CO 80537 INSURER A: United Specialty Insurance Co. 112537 INSURER B : Auto -Owners Insurance Co 118988 INSURER C : INSURER D : rr]VFRAnFS rFRTIFIrATF NI IMRFR• RFVICIr1N NI IMRFR- 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 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 POLICY NUMBER POLICY EFF MMIDD POLICY EXP MMIDD LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY ' h CLAIMS- MADE OCCUR }}}T_ - � - ATN-ATL1760556 08/01l2017 - � � � ' ' 08/0112018 � - - IEACH OCCURRENCE _ AMAGE-TO-RENTED ! PREMISES (Ea occurrence) $ 1,000,00 � 100,00( I $ + {-MED EXP (Any one person) _--- $ 5,00 _ PERSONAL INJURY $ 1,000,00 [GENERAL AL AGGREGATE $ 2,000,00 GEN'L AGGREGATE LIMIT APPLIES PER: _.-� PRO- " POLICY T LOC PRODUCTS - COMP/OP AGG $ 2,000,000 -- $ - - g AUTOMOBILE LIABILITY _ ^ ANY AUTO 4888439100 06/28/2018 • 06/28/2019 COMBINED SINGLE LIMIT Ea accident 1,000,00 BODILY INJURY (Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ HIRED AUTOS X NON -OWNED AUTOS Ix $ UMBRELLA LIAR OCCUR j EACH OCCURRENCE $ EXCESS UAB CLAIMS-MP'E I ��GG—REGATE j $ DED RETENTION $ $ I WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PAR.TNERJEXECUTIVE UFF;(.:ERnbiE M!EER EXLLUDEO? � (Mandatory in NH) If yes, describe under-- DESCRIPTION OF OPERATIONS below I N 1 A -- i I I ; j WC STATU- OTH- I E L EACH ACCIDENT — --- — -- ----,._— I E.L. DISFASE - EA EMPLOYEE! E.L. DISEASE- POLICY LIMIT $ -------- $ — — — $ _ _ j I i DESCRIPTION OF OPERATIONS ! LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) UtK 1 It-ItAI t MULUtK i-rNUL:LLAI IUN CITYFT: City of Fort Collins 330 S. College Ave. P.O. Box 580 Fort Collins, CO 80522-0580 SHCULD ANt OF TiaE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE. Jim Bowes © 1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD