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HomeMy WebLinkAboutGF TECHNOLOGIES INC DBA COMPLETE BASEMENT SYSTEMS - INSURANCE CERTIFICATE (4)COMPBAS-01 EBIELKIEWICZ ACORO CERTIFICATE OF LIABILITY INSURANCE lk� DATE(MM/DD/YYYY) 08/30/2017 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 Jennifer Donohue NAME PHONE (A/C, No, , Ex1): (303) 762-1717 107 ac, No : (303) 762-1733 Forsberg Engerman Co 3575 S Sherman St Englewood, CO 80113 EA-pmpAg'LEss:jennifer@forsberg-engerman.com INSURERS AFFORDING COVERAGE NAIC # INSURER A: Peleus Insurance Company INSURED INSURER B: EMC Insurance Companies 21415 INSURER C : GF Technologies Inc dba Complete Basement Systems INSURER D : 11795 E 45th Ave Denver, CO 80239 INSURER E INSURER F : COVERAGES CERTIFICATE NUMBER: 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 TR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR X 103GLOO1969300 08/30/2017 08/30/2018 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED ISES (Ea occurrence) 50,000 $ MED EXP (Any oneperson) PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY X PE� LOC OTHER: GENERAL AGGREGATE 2,000,000 PRODUCTS - COMP/OP AGG 2,000,000 $ B AUTOMOBILE LIABILITY X ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS X HIRED X NON -OWNED AUTOS ONLY AUTOS ONLY 5E33689 08/30/2017 08/30/2018 COMBINED SINGLE LIMIT $ 1,000,000 BODILY INJURY Perperson) BODILY INJURY Per accident $ PerOP.F.R ntDAMAGE $ A X UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE AUX419502500 08/30/2017 08/30/2018 EACH OCCURRENCE $ 1,000,000 AGGREGATE 1,000,000 DED RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N / A PERTUTE I I OTH- STA ER E.L. EACH ACCIDENT E.L. DISEASE - EA EMPLOYE_ E.L. DISEASE - POLICY LIMIT $ B B Equipment Floater Property 5C33689 5A33689 08/30/2017 08/30/2017 08/30/2018 08/30/2018 Included BPP 750,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) City of Fort Collins is named as an additional insured with respect to general liability per CG2010 04/13 as required by contract. City of Fort Collins Attn: Kaye Mathea PO 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 i ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD