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HomeMy WebLinkAbout582736 RK MECHANICAL INC - INSURANCE CERTIFICATE (7)Client#: 1092527 R KM EC ACORDT. CERTIFICATE OF LIABILITY INSURANCE DATE /DDIYYYY) /23/2018 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 Ab DDITIONAL 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 any rights to the certificate holder in lieu of such endorsement(s). PRODUCER NAME:ACT Client Manager USI Colorado, LLC Construction PHONE g00 873-8500 P.O. Box 7050 LA CANNo Ext : A/C No : 303-831-5295 IL Englewood, CO 80155 ADDRESS: den-contractors@usi.com 800 873-8500 INSURER(S) AFFORDING COVERAGE NAIL # INSURER A: Zurich Nor. Am d" 16535 INSURED INSURER B RK Mechanical, Inc. dba RK Service - 3800 Xanthia Street INSURERC: INSURER D : Denver, CO 80238 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 CONTRACTOR 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 ADDL INSR SUBR WVD POLICY NUMBER POLICY EFF (MM/DD/YYYYZ POLICY EXP MM/DD/YYYY LIMITS COMMERCIALGENERALLIABILIY EACH $ CLAIMS -MADE OCCUR GOECCTURRENCE PREMISES Ea occurrence) $ MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY LJECOT- LOC _J PRODUCTS - COMP/OP AGG $ $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident) BODILY INJURY (Per person) $ ANY AUTO OWNED AAUTOS ONLY SCHEDULED AUTOS BODILY INJURY (Per accident) $ HIRED NON -OWNED AUTOS ONLY AUTOS ONLY PROPERTY DAMAGE Per accident $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE _ $ LIAR CLAIMS -MADE DEXCESS D� RETENTION $ $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY N ANY PROPRIETOR/PARTNER/EXECUTIVE — OFFICER/MEMBER EXCLUDED? N/A X WC980940303 3/01/2018 03/01/2019 OTH- X I PSTEARTUTr E.L. EACH ACCIDENT $1 000 000 E.L. DISEASE - EA EMPLOYEE $1 000 000 (Mandatory in NH) _ If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $1.000.000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) The Workers' Compensaton policy(s) includes an endorsement providing that 30 days notice of cancellation will be given to the Certificate Holder will be given to the Certificate Holder by the Insurance Carrier. &G]Aai 1111 PJL\ If 114l Ral City of Fort Collins SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Attn: Purchasing Department ACCORDANCE WITH THE POLICY PROVISIONS. P.O. Box 580 Fort Collins, CO 80522 AUTHORIZED REPRESENTATIVE ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) 1 of 1 The ACORD name and logo are registered marks of ACORD #S22581808/M22580020 SBCZP