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HomeMy WebLinkAboutMICHAEL BOTTOMS BUILDER LLC - INSURANCE CERTIFICATE (2)MICHBOT-01 LJOHNSON '4coRo CERTIFICATE OF LIABILITY INSURANCE D 12/28TE /2016Y) 12/28/2016 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 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: PFS Insurance Group PHONE Fax 4848 Thompson Parkway Suite 200 (A/C, No, EXq: (970) 635-9400 i (A/c, No):(970) 635-9401 Johnstown, CO 80534 % R ss: info@mypfsinsurance.com INSURER A: United Fire & Casualty Group 13021 INSURED INSURERS: Michael Bottoms Builder LLC INSURERC : Michael Bottoms DBA - -- 3202 Sparrow Hawk Lane INSURER D : Berthoud, CO 80513 INSURER E : INSURER F : Cr1VFRAr_Fq CFRTIGIr'ATF til nIARFR• Do11101r%K1 Kn IneD0O. 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 ADDL TYPEOFINSURANCE — ------__ _._... -—_.._ _--- — TSUBR POLICY NUMBER POLICY EFF POLICY EXPLTR LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE X OCCUR GEN'L AGGREGATE LIMIT APPLIES PER: POLICYll jERe� LOC I OTHER: X �60411268 01/24/2017 01/24/2018 EACH OCCURRENCE 1,000,000 $ pR MGET REoocurcence $ 100'000 $ 5,000 MED EXP.(Any oneperson) PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 PRODUCTS -COMP/OP AGG $ 2,000,000 $ AUTOMOBILE LIABILITY ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOpSWN AUTOS ONLY L AUOTOS ONLDY COMBINED SINGLE LIMIT (Ea accident) BODILY INJURY (Per person _ - �BODILY-INJURY Per accident $ $ - $ PROPER acudeTMnt AMAGE $ 1 $ UMBRELLA LIAB EXCESS LIAB FOCCUR CLAIMS -MADE EACH OCCURRENCE_ AGGREGATE $ $ DED RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUIIVE OFdaoMEnNREXCLUDED? antH If d yes, escribe under DESCRIPTION OF OPERATIONS below N/A PER OTH- TA_T T E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE E.L. DISEASE - POLICY LIMIT $ _ DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space is required) Carpentry City of Fort Collins 215 North Mason Street Fort Collins, CO 80524 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 ACORD 25 (2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD