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HomeMy WebLinkAboutHILLSIDE CONSTRUCTION INC - INSURANCE CERTIFICATE (7)A4C"Ro® CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 03/19/2018 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 endorsement(s). PRODUCER CONTACT Kylie Carey, CISR NAME: and Peterson PHOEFlood Ext : (970) 266-7148 FAX A/CNNo, No): (970) 506-6845 PO Box 578 EMAIL ADDRESS: KCarey@floodpeterson.com INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: BITCO General Insurance Corp 20095 Greeley CO 80632 INSURED INSURER B : Plnnacol Assurance 41190 Hillside Construction, Inc. INSURER C : Indian Harbor Insurance Company 36940 INSURER D : 216 Hemlock Street, Suite B INSURER E : Fort Collins CO 80524 INSURER F : COVERAGES CERTIFICATE NUMBER: CL1831922467 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. INSR LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER P LI Y EFF MM/DD/YYYY POLICY EXP MM/DD/YYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 FX1 100,000 CLAIMS -MADE OCCUR PREMISES Ea occurrence $ MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $ 1,000,000 A CLP3666074 04/01/2018 04/01/2019 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY JECT PRO ❑ LOC PRODUCTS - COMP/OP AGG $ 2,000,000 BLNKT $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ 1,000,000 X BODILY INJURY (Per person) $ ANY AUTO A OWNED SCHEDULED CAP3666075 04/01/2018 04/01/2019 BODILY INJURY (Per accident) $ AUTOS ONLY AUTOS PROPERTY DAMAGE $ X HIRED NON -OWNED X AUTOS ONLY AUTOS ONLY Per accident Underinsured motorist $ 1,000,000 X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 5,000,000 AGGREGATE $ 5,000,000 A EXCESS LIAB CLAIMS -MADE CUP2814387 04/01/2018 04/01/2019 DED I X1 RETENTION $ 10,000 $ WORKERS COMPENSATION PER OTH- X I AND EMPLOYERS' LIABILITY Y / N STATUTE ER E.L. EACH ACCIDENT $ 1,000,000 B ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ N/A 4147214 04/01/2018 04/01/2019 1,000,000 OFFICER/MEMBEREXCLUDEXCLUDED? (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE $ If yes, describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ Professional & Pollution Liability C PECO04563503 04/01/2018 04/01/2019 $2,000,000 / $2,000,000 Ea.Occur./Agg. DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more space is required) ULH I IF-IGA 1 t HULULH City of Fort Collins P.O. Box 580 Fort Collins CO 80522-0580 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