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HomeMy WebLinkAboutMCCAULEY CONSTRUCTORS INC - INSURANCE CERTIFICATE (3)AC40 n® ���IRL/ CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDD/YYYY) 12/28/2017 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 Flood and Peterson PO Box 578 Greeley CO 80632 CONTACT Jennifer Winter CISR NAME: PHONE (970) 506-3206 A/C No: (970) 50 6-6846 ADDRESS:JWinter@floodpeterson.com INSURERS AFFORDING COVERAGE NAIC # INSURER Westfield Insurance Company 24112 INSURED McCauley Constructors, Inc. PO BOX 200 Windsor CO 80550 INSURER B :Pinnacol Assurance 41190 INSURER C : INSURER D : INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER:CL17122821266 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 LTR OF INSURANCE ADDLTYPE INSD R POLICY NUMBER EFF MMLDD/YYYY MMICY L ICY EXP DDNYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A CLAIMS -MADE Fx_] OCCUR DAMAGE To RENTE5_ PREMISES Ea occurrence $ 500,000 X MED EXP (Any one person) $ 5,000 PD Ded: 1 , 000 TRA3373883 1/1/2018 1/1/2019 PERSONAL BADVINJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2 , 000 , 000 POLICY L -- JECOT F-1 LOC PRODUCTS - COMP/OP AGG $ 2,000,000 $ OTHER: AUTOMOBILE LIABILITY (CEO accidentMBINED SINGLE LIMIT $ 1,000,000 BODILY INJURY (Per person) $ A X ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS TRA3373883 1/1/2018 1/1/2019 BODILY INJURY (Per accident) $ PROPERTY DAMAGE ccident Per accident) $ NON -OWNED X HIRED AUTOS X AUTOS $ X Drive Other Car X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 5,00 000 AGGREGATE $ 5,000,000 A EXCESS LIAB CLAIMS -MADE DED I X I RETENTION$ 0 $ TRA3373883 1/1/2018 1/1/2019 B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y/ N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? N (Mandatory in NH) N/A 4097236 1/1/2018 1/1/2019 X PER 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 If yes, descrihe under DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) RE: Contractors License CERTIFICATE HOLDER CANCtLLA I IUN City of Fort Collins PO Box 580 Fort Collins, CO 80522-0580 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 J Winter, CISR/JWINTE ACORD 26 (2014/01) INS025 0014nn ©1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD