HomeMy WebLinkAbout266869 ABS ASSOCIATED BUILDING SPECIALISTS INC - INSURANCE CERTIFICATE (4)ncoRo° CERTIFICATE OF LIABILITY INSURANCE
��. 5/1/2018
FDATE(MMIDD/YYYY)
4/21 /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 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 Lockton Companies
444 W. 47th Street, Suite 900
Kansas City MO 64112-1906
(816) 960-9000
CONTCT
NAME,
PHONE FAX
A/C, No Ext : A/C No):
E-MAIL
ADDRESS:
INSURER AFFORDING COVERAGE
NAIC #
INSURER A: Ohio Security Insurance Company
24082
INSURED ASSOCIATED BUILDING SPECIALTIES, INC.
INSURER B : American Fire and Casualty Company
24066
INSURER C : Colorado Casualty Insurance Company
41785
1352712 3764 IMPERIAL STREET
FREDERICK CO 80516
INSURER D : The Ohio Casualty insurance Company
24074
INSURER E :
INSURER F :
COVERAGES * CERTIFICATE NUMBER: 14095 308 REVISION NUMBER: XXXXXXX
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
ADDL
INSD
SUBR
WVD
POLICY NUMBER
POLICY EFF
MMIDDIYYYY
POLICY EXP
MMIDDIYYYY
LIMITS
B
X
COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE � OCCUR
Y
N
BKA1856071740
5/1/2017
5/1/2018
EACH OCCURRENCE
1,000,000
DAMAGERENTED
PREMISESS ( Ea occurrence
30O 000
MED EXP (Any oneperson)1
O OOO
PERSONAL & ADV INJURY
$ 1,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
POLICY JERCOT- LOC
OTHER:
GENERAL AGGREGATE
$ 2,000,000
PRODUCTS - COMP/OP AGG
$ 2,000,000
$
A
AUTOMOBILE LIABILITY
X ANY AUTO
OWNED SCHEDULED
AUTOS ONLY AUTOSHIRED
IX AUTOS ONLY X AUTOS O ONLDY
Y
N
IIAS1857983294
5/1/2017
5/1/2018
COBI
(EaacccNdentSINGLE LIMIT
$ 1 ,000 O00
BODILY INJURY (Per person)
$ XXXXXXX
BODILY INJURY (Per accident
$ CYY,)(XX
�
PROPERTY DAMAGE
Per accident
$ XXX��XXX
$XXXXXXX
F
X
UMBRELLA LIAB
EXCESS LIAB
X
OCCUR
CLAIMS -MADE
N
N
US01856071740
5/1/2017
5/1/2018
EACH OCCURRENCE
$ 5000000
AGGREGATE
$ S 000000
DED RETENTION $
$ XXXXXXX
WORKERS COMPENSATIONAND EMPLOYERS' LIABILITY Y/N
ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICER/MEMBER EXCLUDED? FN
(Mandatory in NH)
If yes, describe under
DESCRIPTION OF OPERATIONS below
NIA
A
N
XWO1856071740
5/1/2017
5/1/2018
X 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
1
C
INSTALLATION/STORED
MATERIALS
rT
9257
5/1/2017
5/1/2018
$475,000LIMIT
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
CITY OF FORT COLLINS IS ADDITIONAL INSURED ON GENERAL, AND AUTO COVERAGE, IF REQUIRED BY WRITTEN CONTRACT AND
SUBJECT TO THE TERMS AND CONDITIONS OF THE POLICY.
la_K I IFII.A I t r1ULUtK r 1WIN
14095308
CITY OF FORT COLLINS
PO BOX 580
FORT COLLINS CO 80524
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
Arnan oc /9n1a1n41
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