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HomeMy WebLinkAboutBALANCE POINT HEATING & AIR CONDITIONING - INSURANCE CERTIFICATE (3)OR>D� CERTIFICATE OF LIABILITY INSURANCE DATE I MMIDDIYYYY) 08/16/2017 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 Pinnacol Assurance NAME: PHONE FAX _ ......... 7501 E Lowry Blvd AJc No Ext: Denver. CO 80230-7006 E ,M ol«_ __ JN3UKEKAJ•h(JKDING COVERAGE NAIC # INSURER A: Pinnacol Assurance ---- 41190 INSURED INSURER B : Balance Point Heating & Air Conditioning 316 Commerce Drive INSURERC: i ................................................................_........__................................................--........................................................................................................................................ Fort Collins, CO 80524 INSURER D: INSURER E : COVERAGES CFRTIFICGTF NI IMRFR• 1219:111Cl J J.n rnAMCD- 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. .... POLICY EFF .-....POLICY EXP..... INSR I ...................... ........................ ADDLSUBR F LTR 1 TYPE OF INSURANCE I POLICY NUMBER MMIDDIYYYY MMIDDIYYYY ..-...�.._...... ___.......... ....................... ... _.__ LIMITS . COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE. $ CLAIMS -MADE u OCCUR .......b..................... . . _ ._. _........... .......... DAMAGE TO RENTED PREMISES Ea occurrence. $ i MED EXP (Any one person) s _ PERSONAL & ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ PRO- POLICY _ JECT LOC ? PRODUCTS - COMP.OP AGG $` -- _ OTHER' ................. .. ._.....-....... .... ....................... .. ......_...... $ AUTOMOBILE LIABILITY `y COMBINED SINGLE LIMIT i $ ..........._.. (Ea.accdent). ............. _..................... i............ _....... .....__ ._ _....- ........ ANY AUTO BODILY INJURY (Per person) i $ OWNED AUTOS ONLY SCHEDULEDAUTOS ; .BODILY INJURY (Per accident) -$ HIRED NON -OWNED PROPERTY DAMAGE I $ AUTOS ONLY AUTOS ONLY jeer acddentl S UMBRELLA LIAB !_ OCCUR EACH OCCURRENCE. $ EXCESS LIAB CLAIMS MADE — .................... _ ......... .. _... ........ ............._........._ .......................................................... AGGREGATE $ ............ _............_. ............................. _... _................................. DED RETENTION S 5 WORKERS COMPENSATION PER OTH- i X AND EMPLOYERS' LIABILITY Y I N I STATUTE __.__. t—}.__...•.. . _.._... i ANYPROPRIETOR/PARTNERIEXECUTIVEA OFFICER/MEMBEREXCLUDED? NIA 4116227 08/01/2018 E.L. EACH ACCIDEN T ; $ 1,000,000 (Mandatory in NH) 1 E.L. DISEASE - EA EMPLOYEE; $ 000,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICYLIMIT , $ 1,000,000 i DESCRIPTION OF OPERATIONS I LOCATIONS ! VEHICLES (ACORD 101. Additional Remarks Schedule, may be attached if more space is required) Unless otherwise stated in the policy provisions, coverage is in Colorado only. Refer to the Acord 101 Additional Remarks Schedule for supplemental cancellation otification information. Excluded (If any) : Jamie Kusmik, William L Kusmik CERTIFICATE HOLDER CANCELLATION 1824462 Fort Collins Utilities Kaye Mathea 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 Renaissance Insurance Group, LLC ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD