HomeMy WebLinkAboutCORE CONTRACTORS INC - INSURANCE CERTIFICATE (3)L CERTIFICATE OF LIABILITY INSURANCE
DATE (MMFDDr"W)
01 /15/2018
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 certfts to does not confer rights to the certificate holder in lieu of such endorsement(s).
PRODUCER
Pinnacol Assurance
7501 E. Lowry Blvd,
Denver, CO 80230-7006
INSURED
Core Contractors, Inc.
4049 St. Paul Street.
Denver. CO 80216
c:
INSURER F
Pinnacol Assurance
COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
41190
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOTVATHSTANDING 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.
iLmTR* — ......... ............. ..._.... ADOL'i3UBR,� .... .......... .............
7YPEOFINSURANCE POLICY NUMBER
_..._POLICY EFF POLICY EXP .._.__....... _... ...__.. ......... __._..._ _ ...
MMID MM+OD LIMMI
..... COMMERCIAL GENERAL LIABILITY
EACH OCCURRENCE € $
;
. .....;
tS W..AGE TO RENTED......_. ... _.........._..._........._
CLAWS -MADE -, OCCCUR � �
i PREMkSES naculnrare I �
i
'',...�.�........ _........ ......__....._�_-...._...___ ._..__._._�..
i MED EXP one rson $
I PERSONAL b ADV INJURY I $
GEN'L AGGREGATE L€MIT APPLIES PER:
1 GENERAL AGGREGATE . $
.... ..
PRJE
POLICY . _co-T Loc
.... ........... . ....... _...----..........----......
PRODUCTS -COMPIOPAGG $
OTHER
$
AUTOMOBILE LIABILITY t
' COMBINESINGLE LIMIT$
ANY Alrl'O
? BODILY INJURY (Per perwo) is
OWNED SCHEDULED
i
BODILY INJURY (Par axidettp $
AUTOS ONLY AUTOS
HIRED NON-ONMED
I Pri'ERTY DAMAGE -
.. _ AUTOS ONLY _...,. , AUTOS ONLY
UMBRELLALIAB OCCUR
EACHOCCtRRRi $
t
EXCE5$LlA6 1 CLAIMS-MADEI
AGGREGATE ±_._.__
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DEO RETENTIONS
$
WORKERS COMPENSATION
€
X_ STATUTE L.. �_ i
AND EMPLOYERS' LIABILITY YIN
........_..-.....................................
ANYPROPRtE*cxz�.�RTNEREx c1 1VE
A OFFiCER1MEMBEREXCLUDED? 4152393
01/0112018!01/01/2019 E.LEACHACC.OENT $500,000
(Mandatory in NH) ',.
E.t DISEASE... EA EMPLOYEE: $ 500,000
It yes, describe under
DESCRIPTION OF OPERATIONS below
, ............................................................ .. ...
I E.L. DISEASE - POLICY LIMIT ' $ 500,000
DESCRIPTION OF OPERATIONS 1 LOCATIONS t VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
nless otherwise stated in the policy provisions, coverage is in Colorado only. Refer to the Acord 101 Additional Remarks Schedule for supplemental cancellation
otification information.
Excluded (If any)
L:tK I It'IL:A I t MULLJtK UAIYL:tLLA I ItJN
1862219
City of Fort Collins SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
PO Box 580 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
Fort Collins, CO 80522 ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE
Associates Insurance Group
O 1988-2015 ACORD CORPORATION. All rights reserved.
ACORD 25 (201 M3) The ACORD name and logo are registered marks of ACORD
ACORDs provided by Forms Bass. www.FormsBoss.com: (c) Impressive Publishing 800-208-1977