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Home My WebLink About130163 EMPIRE CARPENTRY - INSURANCE CERTIFICATE (5)AC"R>D® CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDD/YYYY) 10/16/2017 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 John C Beckett and Associates Inc CONTACT Victoria Rendon NAME: o Ext (970)484-2805 Fn/c, No): (970)484-2885 PHONE AIC No, E-MAILADDRESS: vickie@beckettinsurance.com 220 Smith Street INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: Addison Insurance Company 10324 Ft. Collins CO 80524 INSURED INSURER B : INSURER C EMPIRE CARPENTRY LLC INSURER D : PO BOX 245 INSURER E INSURER F : BELLVUE CO 80512-0245 GOVEKAUhb %.'r=r%rirl.^+ nvmuu.. --- 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. IN R LTR TYPE OF INSURANCE X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE � OCCUR INSD WVD POLICY NUMBER POLICY EFF MMIDD/YYYY POLICY EXP MM/DD/YYYY LIMITS EACH OCCURRENCE $ 1,000,000 PREMISES Ea occurrence $ 100,000 MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $ 1.000,000 A Y 60378006 10/30/2017 10/30/2018 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: X POLICY PRO- LOC JECT PRODUCTS - COMP/OP AGG $ 2,000,000 Liquor Liability Exclusion $ OTHER AUTOMOBILE LIABILITY (Ea acccidentINED SINGLE LIMIT $ BODILY INJURY (Per person) $ ANY AUTO BODILY INJURY (Per accident) $ OWNED SCHEDULED NO COVERAGE AUTOS ONLY AUTOS HIRED NON -OWNED AUTOS ONLY AUTOS ONLY PROPERTY DAMAGE Per accident)$ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE NO COVERAGE DED RETENTION $ WORKERS COMPENSATION PER OTH- STATUTE ER $ E.L. EACH ACCIDENT $ AND EMPLOYERS' LIABILITY Y I N ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ OFFICER/MEMBER EXCLUDED? (Mandatory in NH) N / A NO COVERAGE E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE -POLICY LIMIT $ If yes, describe under DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) CERTIFICATE HOLDER IS ADDITIONAL INSURED PER WRITTEN CONTRACT ON THE GENERAL LIABILITY FOR THE ONGOING OPERATIONS OF THE NAMED INSURED. GtK I II-IGA I t MULUtrC 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. 215 NORTH MASON ST AUTHORIZED REPRESENTATIVE PO BOX 580 f FT. COLLINS CO 80522 �r` ' ( 1717dtS-LU70 HtiVrtv �.vrcrvrw rrvn. nu nynw �wc�.c.,. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD