Loading...
HomeMy WebLinkAbout453145 INDEPENDENT ROOFING SPECIALISTS - INSURANCE CERTIFICATE (4)Page 1 of 1 ACOR" CERTIFICATE OF LIABILITY INSURANCE DATE(MM/ 12/28/017 2017Y) 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 CONTACT NAME: Willis of Colorado, Inc. c/o 26 Century Blvd P.O. Sox 305191 PHONE FAX o Ex 1-877-945-7378 A/C No: 1-888-467-2378 E-MAIL certificates@willis.com ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC# Nashville, TN 372305191 USA INSURER A: United Specialty Insurance Company 12537 INSURED Independent Roofing Specialists, LLC Attn: Jeremy Shull INSURERB: Ohio Casualty Insurance Company 24074 INSURERC: Pinnacol Assurance Company 41190 INSURERD: 4995 Locust St INSURER E Commerce City, CO 80022 USA INSURER F : Cf1V9RAnFC RFRTIFICGTF NIIMRFR• W4900624 REVISION Nt1MRFR- 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 ADDLSUBRTYPE INSD WVD POLICY NUMBER POLICY EFF D MMDNYY POLICY XP D MM DN LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR ATN-SFIS41356 01/01/2018 01/01/2019 EACH OCCURRENCE $ 1,000,000 PREM SES (E. occurrRENTEence) $ 50,000 MED EXP (Any one person) $ 0 PERSONAL & ADV INJURY $ 1,000,000 GEN'LAGGREGATE LIMIT APPLIES PER: POLICY X PEA LOC OTHER: GENERAL AGGREGATE $ 2,000,000 PRODUCTS $ 2,000,000 $ B AUTOMOBILE LIABILITY X ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED AUTOS ONLY AUTOS ONLY BAS (19) 56290543 01/01/2018 01/01/2019 COMBINED SINGLE LIMIT Ea accident $ 1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ A UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE XS-BTN1744326 01/01/2018 01/01/2019 EACH OCCURRENCE $ 11000,000 X AGGREGATE $ 1,000,000 DED I X RETENTION $ 0 $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANYPROPRIETOR/PARTNER/EXECUTIVE Y / N OFFICER/MEMBER EXCLUDED? Yes (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N/A 4096550 01/01/2018 01/01/2019 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 11, 000, 000 1 $ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) CERTIFICATE HOLDER L;ANUhLLA I IUN 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 City of Fort Collins P.O. Box 580 Fort Collins, CO 80522 © 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD sR TD: 15462509 BATCH: 553138