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HomeMy WebLinkAbout414575 MAXIMUM PAINTING LLC - INSURANCE CERTIFICATE (8)ACORU0 AC� CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 11/28/2017 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 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 Flood and Peterson PO Box 578 Greeley CO 80632 CONTACT K lie Care CISR NAME: y y TFAX PHONE (970)266-7148 A/C No:(970)506-6845 MAIL KCare @flood eterson.com E-MAIL-ADDRESS: ADDRESS: y P INSURERS AFFORDING COVERAGE NAIC # INSURERA:Westfield Insurance Company 24112 INSURED Maximum Painting, LLC 412 S. Howes St., Ste. C Fort Collins CO 80521 INSURER B :Pinnacol Assurance 41190 INSURER C : INSURERD: INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER:CL17112820675 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 OF INSURANCE L ADDTYPE BR POLICY NUMBER POLICY EFF MM/DDIYYYY POLICY EXP MM/DD/YYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A CLAIMS -MADE OCCUR DAMAGE TOEa RENTEDoccu PREMISES rrence $ 500,000 MED EXP (Any one person) $ 5,000 TRA3290427 12/1/2017 12/1/2018 PERSONAL 8 ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2 , 000 , 000 POLICY 7 JECOT- LOC PRODUCTS - COMP/OP AGG $ 2,000,000 Employee Benefits $ 1,000,000 OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ 1,000,000 X BODILY INJURY (Per person) $ A ANY AUTO ALL OWNED X SCHEDULED AUTOS AUTOS TRA3290427 12/1/2017 12/1/2018 BODILY INJURY (Per accident) $ X PerOPER tDAMAGE c. $ X NON -OWNED HIRED AUTOS AUTOS Underinsured motorist $ 1,000,000 X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 5 000 000 AGGREGATE $ 5,000,000 A EXCESS LIAB CLAIMS -MADE DED I X RETENTION$ 0 $ TRA3290427 12/1/2017 12/1/2018 B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? � (Mandatory in NH) N/A 4104129 5/1/2017 5/1/2018 X PER OTH- STATUTE ER E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 1,000,000 A Leased/Rented Equipment TRA3290427 12/1/2017 12/1/2018 $55,000 Limit/$500 Deductible DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Certificate holder is included as Additional Insured as required by written contract with respects to liability arising out of work performed by the named insured, respects to the Auto Liability and General Liability policies. CERTIFICATE HOLDER CANCELLATION (970)221-6707 jwilson@fcgov.com City of Fort Collins P.O. Box 580 Fort Collins, CO 80522 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 K Carey, CISR/KCAREY � f �" ACORD 25 (2014/01) INS025 ont4mi ©1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD