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HomeMy WebLinkAbout521758 SUMMIT SEALANTS INC - INSURANCE CERTIFICATE (4)SUMMSEA-02 AL_" K" DATE (MM/DD/YYYY) �� CERTIFICATE OF LIABILITY INSURANCE 6l112017 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 HUB International Insurance Services (COL) 2742 Crossroads Blvd. Grand Junction, CO 81506 INSURED Summit Sealants, Inc. 13671 Carefree Drive Montrose, CO 81403 Lynn Bosman rt, (3031 252-3762 INSURER F : Union Insurance Company St. Paul Fire 8r Marine Insurance Pinnacol Assurance Company Westchester Surplus Lines Insu !�A\iCDAI�CC !`COTICIr`ATC wII IIIIIDCD• 0C\/ICIrlk1 til li{ARCt]- 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 INSD SUBR WV POLICY NUMBER POLICY EFF MMIDD POLICY EXP D LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE X OCCUR X X CGL0036925 06/01/2017 06/01/2018 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED PR MI a occurrence 100�QQQ $ MED EXP (Any oneperson) $ 5,000 PERSONAL & ADV INJURY $ 1,000,U00 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY [XI jre7 1 7X 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 SSVyN AUTOS ONLY r AUOTOS ONLDY X X CPA3135992-21 06/01/2017 06/01/2018 EGaccidentSINGLE LIMIT $ 1,000,000 BODILY INJURY Perperson) $ BODILY INJURY Per accident $ _ $ PROPERTY DAMAGE Per accident $ C X UMBRELLA LIA13 EXCESS LIAB X OCCUR CLAIMS -MADE ZUP13TO4762 06/01/2017 06/01/2018 EACH OCCURRENCE $ 10,000,000 AGGREGATE $ 10,000,000 DED I X I RETENTION $ 10,000 $ _ D WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ FCER/MEMBER EXCLUDED? ManFIdatoryin NH) If yes, describe under DESCRIPTION OF OPERATIONS below NIA X 4076879 06/01/2017 06/01/2018 X I STATUTE ERH E.L. EACH ACCIDENT 1,000,000 $ E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE - POLICY LIMIT 1,000,000 $ E E Pollution Liability Pollution Liability X X X X G46645017001 G46645017001 06/01/2017 06/01/2017 06/01/2018 06/01/2018 Each Condition Aggregate 2,000,000 2,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Project: Civic Center Parking Garage City of Fort Collins is an additional insured for General Liability. [ha:1112LhG\la City of Fort Collins 300 W Laport Building B 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 ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD