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HomeMy WebLinkAboutMB ROOFING INC - INSURANCE CERTIFICATE (4)MBROO-2 OP ID: E1 ACORO CERTIFICATE OF LIABILITY INSURANCE ATE (MM/DD/YYYY) r02/22/2017 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 Brown & Brown of Colorado, Inc 2170 S. Parker Rd Ste 251 Denver, CO 80231 CONTACT NAME: Evie Jo Ontiveros PHONE FAX vC No Ext : 720-963-4286 A c No : 720-962-5142 ADDRESS eontiveros@bbdenver.com Jason Sartor INSURER(S) AFFORDING COVERAGE NAIC # INSURER A:Secura Insurance Co. 22543 INSURED MB Roofing, Inc. INSURER B : Pinnacol Assurance Company 41190 Mark & Terry Brady INSURER C: NATIONAL UNION FIRE INS. CO. 19445 PO Box 1289 Commerce City, CO 80022 INSURER D : Peleus Insurance Company 34118 INSURER E : Rockhill Insurance Co 28053 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 LTR TYPE OF INSURANCE ADDL SUB POLICY NUMBER MM/DD/YYYY MM/DD/Y YY LIMITS D X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 CLAIMS -MADE E OCCUR X AU4190011-00 03/01/2017 03/01/2018 ERENTED PREMIEa occurrence PREMISESS $ 50,00 MED EXP (Any one person) $ 5,00 PERSONAL & ADV INJURY $ 1,000,00 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,00 POLICY F JE LOC PRODUCTS -COMP/OP AGG $ 2,000,00 $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea ccident a $ 1,000,00 BODILY INJURY (Per person) $ A X ANY AUTO A3174667 03/01/2017 03/01/2018 BODILY INJURY (Per accident) $ ALL OWNED SCHEDULED AUTOS AUTOS NON OWNED HIRED AUTOS AUTOS PROPERTY DAMAGE Per accident $ UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 1,000,00 X AGGREGATE $ 1,000,00 C EXCESS LIAB CLAIMS -MADE EBU015223565 03/01/2017 03/01/2018 DED X RETENTION $ 0 $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? N� (Mandatory in NH) N / A 4027282 03/01/2017 03/01/2018 X PER OTH- STATUTE ER E.L. EACH ACCIDENT $ 1,000,00 E.L. DISEASE - EA EMPLOYEE $ 1,000,00 E.L. DISEASE - POLICY LIMIT 1 $ 1.000,00 If yes, describe under DESCRIPTION OF OPERATIONS below A Lease/Rent Eq CP3174666 03/01/2017 03/01/2018 Lease/Ren 100,00 E Pollution Liab ENVP007803-03 03/01/2017 03/01/2018 Poll Liab 1,000,00 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Per policy terms, conditions and exclusions. City of Fort Collins is an additional Insured for General Liability as required by written contract. CERTIFICAI E FTCOLLC City of Fort Collins PO Box 580 Ft Collins, CO 80526 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 © 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD