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HomeMy WebLinkAbout262877 RTN ROOFING SYSTEMS - INSURANCE CERTIFICATE (4)ACORO0 AC� CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 3/21/2017 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 CONTACT Renee McReynolds Ewing -Leavitt Insurance Agency, Inc. AAC o E:t. (970) 679-7344 � Nu: (666)425-6180 4090 Clydesdale Parkway E-MADDRESS:renee-mcreynolds@leavitt.com INSURERS AFFORDING COVERAGE NAIC # Suite 101 INSURERA:United Fire & Casualty 13021 Loveland CO 80538 INSURED INSURER B :Pinnacol Assurance 41190 INSURERC: RTN Roofing Systems LLC 5854 Lockheed Ave INSURERD: INSURER E : INSURER F Loveland CO 80538 COVERAGES CERTIFICATE NUMBER:17-18 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 I ADDL SUBR POLICY EFF- I POLICY EXP LTR TYPE OF INSURANCE POLICY NUMBER MM/DD/YYYY) I iMMIDDfYYYYi LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE 7 OCCUR EACH OCCURRENCE $ 1,000,000 _ DAMAGE TO RENTED PREMISES Ea occurrence 500,000 $ X MED EXP (Any one person) $ 5,000 Blkt Addl Insureds 60488595 4/1/2017 4/1/2018 x Blkt Waiver of Subrog PERSONAL& ADV INJURY $ 1,000,000 GENT AGGREGATE LIMIT APPLIES PER: X PRO POLICY JECT LOC GENERAL AGGREGATE $ 2,000,000 incl Jobsite Pollution PRODUCTS - COMP/OPAGG $ 2,000,000 !$ OTHER: $100,000 limit AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ 1 , 000 , 000 X BODILY INJURY (Per person) _ $ $ A ANY AUTO AOSCHEDULED AUTOS AUTOS 60488595 4/1/2017 4/1/2018 URYP BODILY INJURY accident ( ) X HIRED AUTOS X NON -OWNED AUTOS PROPERTY DAMAGE Per accident _ $ X $ Blkt WOS X Blkt Addl Insureds X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 1,000,000 AGGREGATE $ 1,000,000 A XCESS LIAB �DED CLAIMS -MADE I I RETENTION$ 0 $ 60488595 4/l/2017 4/1/2018 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 N/A Incl Blanket Waiver of Subrogation 4054406 4/1/2017 4/1/2018 x PER OTH- STATUTE ER E.L. EACH ACCIDENT $ 500 000 E.L DISEASE - EA EMPLOYE $ 500,000 E.L. DISEASE - POLICY LIMIT 1 r - $ 500,000 A Contractors' Equipment 60488595 4/1/2017 4/1/2018 Installation Floater i $50,000 LimiU$500 ded DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) L,cm I Irltii l r- r1ULUr-M L ANUtLLAI IUN City of Fort Collins 700 Wood Street Fort Collins, CO 80521 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 R McReynolds/RESTEIe�`�'h ACORD 25 (2014101) INS025 (201401) ©1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD