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HomeMy WebLinkAboutMICHAEL NOELLER CONTRACTING LLC - INSURANCE CERTIFICATE (6)ACORN® CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 10/2612017 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 NAME: Janice Aaron The Reilly Company LLC PHONE (913)682-1234 AX (913)682-8136 A/C No Ext : A/C, No : 608 Delaware St. E-MAIL ADDRESS: ) @y anice.aaron refill Ir1SUfanCe.COm P.O. BOX 9 INSURER(S) AFFORDING COVERAGE NAIC # Leavenworth KS 66048-0009 INSURER A : Nationwide (Allied) 00035 INSURED INSURERS: Michael Noeller Contracting, LLC INSURER C : PO BOX 602 INSURER D : INSURER E : Liberty MO 64069 INSURER F : COVERAGES CERTIFICATE NUMBER: Master 17 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, ILTR TYPE OF INSURANCE INSD WVD POLICY NUMBER (MM DD/YYYY) (MMIDD/YYYY) LIMITS X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE � OCCUR EACH OCCURRENCE $ 1.000,000 PREMISES Ea occurrence $ 100,000 MED EXP (Any one person) $ 10,000 PERSONAL & ADV INJURY $ 1,000,000 A ACP 3027352616 10/31/2017 10/31/2018 GEN'L AGGREGATE LIMIT APPLIES PER POLICY � PRO ❑ JECT LOC GENERAL AGGREGATE $ 2,0001000 PRODUCTS -COMP/OP AGG 2,000,000 $ $ OTHER AUTOMOBILE LIABILITY COMB INED SINGLE LIMIT Ea accident s 1,000,000 X BODILY INJURY (Per person) $ ANY AUTO A OWNED SCHEDULED AUTOS ONLY AUTOS ACP BAA 3027352616 10/31/2017 10/31/2018 BODILY INJURY (Per accident) $ X HIRED X NON -OWNED AUTOS ONLY AUTOS ONLY PROPERTY DAMAGE Per accident $ Underinsured motorist s 1,000,000 X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 5,000,000 AGGREGATE $ 5,000,000 A EXCESS LIAB CLAIMS -MADE ACP CAA 3027352616 10/31/2017 10/31/2018 DED F I RETENTION $ $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE YIN OFFICER/MEMBER EXCLUDED? El (Mandatory in NH) if yes, describe under DESCRIPTION OF OPERATIONS below ACP WC 3027352616 10/31/2017 10/31/2018 PER OTH- X STATUTE ER E.L. EACH ACCIDENT $ 500,000 E.L. DISEASE - EA EMPLOYEE $ 500,000 E.L. DISEASE -POLICY LIMIT 500,000 $ A Leased/Rented Equipment ACP 3027352616 10/31/2017 10/31/2018 Limit $400,000 Deducbtible $1,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Fort Collins ACCORDANCE WITH THE POLICY PROVISIONS. PO Box 580 AUTHORIZED REPRESENTATIVE Fort Collins CO 80522-0580 A Aa,,o, -. ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD