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Home My WebLink About563449 CENTERLINE SOLUTIONS LLC - INSURANCE CERTIFICATE (6)C� ® DATE (MM/DD/YYYY) A C" CERTIFICATE OF LIABILITY INSURANCE F/23/2018 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 Arthur J. Gallagher Risk Management Services, Inc. 1515 Fortino Blvd Suite 200 Pueblo CO 81008 INSURED CALVTUR-01 Calvin Turner Roofing LLC 3128 West 12th St. Pueblo, CO 81003 NAMF Stephanie Van Buskirk (acNt o Ezt): 719-544 1111 No): 719 545 5120 noI R1Ess: stephanie_vanbuskirk@ajg.com INSURER(S) AFFORDING COVERAGE NAIC A INSURERA:CSU Producer Resources, Inc. INSURER B:Cincinnati Insurance Company 10677 INSURER c:Pinnacol Assurance Company 41190 INSURER D : F: COVFRARFS CFRTIFICATF NI IMRFR• 1709106047 RF1/ISIn1U NI IMRFP- 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 INSD WVD POLICY NUMBER POLICY EFF MWDD/YYYY POLICY EXP MIWDD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE X❑ OCCUR CSGA4087 CSU0109004 1/5/2018 1/5/2019 EACH OCCURRENCE $1,000,000 11ES(EaoccED PREMISES Ea occurrence $100,000 X MED EXP (Any one person) $5,000 X CSGA437 PERSONAL & ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO- LOC JECT OTHER: GENERAL AGGREGATE $2,000,000 %( PRODUCTS - COMP/OP AGG $ 2,000,000 $ B AUTOMOBILE LIABILITY ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED AUTOS ONLY X AUTOS ONLY ENP0473293 1/20/2018 2/1/2019 Ea accident $ 1,000,000 X BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ X PROPERTY DAIWAGE- Per accident $ $ UMBRELLA LIAB EXCESS EXCESS LAB OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ I I RETENTION $ $ C 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 4128974 2/1/2018 2/1/2019 P OTH- STATUTE ER E.L. EACH ACCIDENT $1,000,000 E.L. DISEASE - EA EMPLOYEE $1,000,000 E.L. DISEASE - POLICY LIMIT $1,000,000 B Leased/Rented Equip ENP0473293 1/20/20111 2/1/1019 Limit 40,000 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if rnore space is required) Roofing Contractor CERTIFICATE HOLDER CANCELLATION City of Fort Collins PO Box 580 Fort 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 0 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD