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109363 ALLIANCE CONSTRUCTION SOLUTIONS LLC - INSURANCE CERTIFICATE (7)
® DDIYYYY) A!^'� DATE (MM/ CERTIFICATE OF LIABILITY INSURANCE 12/22/2016 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 CONTACT Y NAME: Mar Cole, CIC Flood and Peterson PHONE (970) 356-0123 l FAX No): (970) 330-1867 PO Box 578 e M o1��S.MCole@floodpeterson, com Greeley CO 80632 INSURED Alliance Construction Solutions, LLC 2260 Broadway INSURER 5 AFFORDING COVERAGE NAIC # A.L.iberty Mutual Insurance Group 23043 _ B:Liberty Mutual Insurance Co 23043 C:Pinnacol Assurance. 41190 +Denver CO 80205 1 INSURER F: COVFRAr;FS CFRTIFICATF NIIMRFP-CL16122215258 REVISION NIIMRER- 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 A L UB POLICY NUMBER EFF MWDDIYYYY MM/DDPOLICY Y EXP YYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A CLAIMS -MADE EI OCCUR DAMAGE TO RENTED PREMISES Ea occurrence $ 1 , 000 , 000 X MED EXP (Any one person) $ 10,000 $25, 000 PD DED TB2Z91466781027 1/1/2017 1/1/2018 PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER. RO POLICY a JE LOC PRODUCTS - COMP/OP AGG $ 2,000,000 $ OTHER. AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ 1,000,000 BODILY INJURY (Per person) $ B X ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS AS2Z91466781017 1/1/2017 1/1/2018 BODILY INJURY (Per accident) $ PROPERTY DAMAGE Peraccident NON -OWNED X HIRED AUTOS X AUTOS $ _ Uninsured motorist combined $ 1,000,000 X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 10,000,000 AGGREGATE $ 10,000,000 A EXCESS LIAB CLAIMS -MADE DIED I X I RETENTION$ 10,000 $ TH7Z91466781037 1/1/2017 1/1/2018 WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN XI PER OTH- STATUTE ER C ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? N❑ (Mandatory in NH) N /A 4038468 1/1/2017 1/1/2018 E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 If yes, aescribe unaer DESCRIPTION OF OPERATIONS below I E.L. DISEASE - POLICY LIMIT - 1 $ 1,000,000 D Leased S Rented Equipment QT660BF328292TIL17 1/1/2017 1/1/2018 $350,000 Limit $1,000 Ded D Builders Risk I QT6606F328292TIL17 1/1/2017 1/1/2018 � $SMM/$15MMPer Constr.Type $5,000 Ded DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) RE: Contractor's License A-96 l.tK I II -ILA I C nvL.LCK 1 IUIV City of Fort Collins PO 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 Morgan, CLCS, CISR/ LC'• �/Yloa. © 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD INSn25 r?nlann