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HomeMy WebLinkAboutCALVIN TURNER ROOFING LLC - INSURANCE CERTIFICATE (3)AC �® DATE (MM/DD/YYYY) �,, CERTIFICATE OF LIABILITY INSURANCE 1/9/2018 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 endorsements . PRODUCER CONTACT NAME: Stephanie Van Buskirk Arthur J. Gallagher Risk Management Services, Inc. PHONE FAX 719 544 1111 a Not 719-545-5120 1515 Fortino Blvd Suite 200 E-MAIL Pueblo CO 81008 Stephanie P _vanbuskirk@aJgcom INSURER(S) AFFORDING COVERAGE NAIC 0 A:CSU Producer Resources, Inc. INSURED CALVTUR-01 Calvin Turner Roofing LLC 3128 West 12th St. Pueblo, GO81003 INSURER B : INSURERC: INSURERD: Cr11/FRAr:FC r GDTIFICATG IW IRARCD. RnRQAn irn or1ncrnar nu rnaOro. 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 15 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 SD WV POLICY NUMBER POLICY EFF MMIDDIYYYY POLICY EXP MPWDDIYY LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE X� OCCUR CSGA4087 CSU0109004 1/5/2018 1/5/2019 EACH OCCURRENCE $1,000,000DAMAGETO PREMISES Ea occurrence _ $100,000 X MED EXP (Anyone person) $5,000 X CSGA437 PERSONAL & ADV INJURY $1,000,000 GEN'L X AGGREGATE LIMIT APPLIES PER: POLICY ❑ PRO- JECT LOC OTHER: GENERAL AGGREGATE f 2,000,000 PRODUCTS -COMP/OP AGG E2,000,000 E AUTOMOBILE LIABILITY ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED AUTOS ONLY AUTOS ONLY COME Ea accident BODILY INJURY (Per person) $ BODILY INJURY (Per accident) E Per accident = E UMBRELLA LIAR EXCESS LIAB OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE E DED RETENTION E $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below NIA STATUTE ERH E.L. EACH ACCIDENT E E.L. DISEASE - EA EMPLOYE S E E.L. DISEASE - POLICY LIMIT DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If rnore space Is required) Roofing Contractor GLK ILA I L HULUtH GANGLLLAI IUN 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 REPRESENT © 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD