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PARAMOUNT REMODELING INC - INSURANCE CERTIFICATE (3)
DATE (MMIDDIYYYY) A� o® CERTIFICATE OF LIABILITY INSURANCE F5/17/2017 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 endorsements . PRODUCER CONTNAME: Shana Phillips _ Arthur J. Gallagher Risk Management Services, Inc. P►+timE _- FAX 3005 Center Green Drive Suite 120 (A/C.No Frr)_ 303-444-4666 303-444-8481 Boulder CO 80301 E-MAILSS, Shana_Phillips@ajg.com INSURED PARAREM-01 Paramount Remodeling Inc. Paramount Electric Martin Maxwell 8105 W 125 Frontage Rd. #5 Frederick CO 805169465 A:Addison Insurance Company 110324 B:Pinnacol Assurance Company 141190 RER D : C/IVFRAr:FC r_FRTIFIr:ATF NI IMRFR• 986270976 RF\/IG1r1N NI IMRFR• 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. IR LT LTR TYPE OF INSURANCE 1 WVD' POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MMIDDIYYYY LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE XF OCCUR 60306641 1/11/2017 1/11/201B EACH OCCURRENCE $1,000,000 PRE $100,000 MED EXP (Any one person) $5,000 PERSONAL & ADV INJURY $1,000,000 GENT AGGREGATE LIMIT APPLIES PER: X POLICY PRO ❑ LOC JECT OTHER: GENERAL AGGREGATE $2,000,000 PRODUCTS - COMP/OP AGG $2,000,000 $ AUTOMOBILE LIABILITY ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED AUTOS ONLY AUTOS ONLY COMBINED 5INGLE LIMIT Ea accident $ BODILY INJURY (Per person) $ $ BODILY INJURY (Per accident) 0PERT4-DAMAGE— Peraccident $ UMBRELLA LIAR EXCESS LIAR OCCUR CLAIMS - MADE EACH OCCURRENCE $ AGGREGATE $ DED RETENTION $ $ B 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 NIA 4114449 12/l/2016 12/1/2017 X PEROTH- STATUTE ER E.L. EACH ACCIDENT $500,000 - E.L. DISEASE - EA EMPLOYEE $500,000 E.L. DISEASE - POLICY LIMIT ! $500,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION City of Fort Collins PO BOX 580 Fort Collins CO 80522 USA SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. REPRESENTATIVE © 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD