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HomeMy WebLinkAboutBLUSKY RESTORATION CONTRACTORS INC - INSURANCE CERTIFICATE (5)DATE (MM/DD/YYYY) AC"RO® CERTIFICATE OF LIABILITY INSURANCE 4/28/2017 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 Arthur J. Gallagher Risk Management Services, Inc. 6300 South Syracuse Way, Suite 700 Centennial CO 80111 INSURED BIusky Restoration Contractors, Inc. 9767 E. Easter Ave. Centennial, CO 80112 Wr'IA"I NAME: Brett Lewis PHONE _WCNa,�U. 303-889-2542 FAx _a). 303-889-2545 MESS" brett_lewis@ajg.com INSURERS AFFORDING COVERAGE NAIC N INSURERA:Tokio Marine Specialty Ins Co 23850 _ INSURER B:Liberty Mutual Fire Insurance Coma 23035 INSURER c:Philadelphia Indemnity Insurance Co 18058 INSURER D : r n%1rDA(_FC rGDTIFICATG PWIMRGD. 2n49524351 D971/IC-I(1M MIIRRRPD- 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. ILTR TYPE OF INSURANCE NSD D POLICY NUMBER MMIDDIYYYYPOLICY EFF POLICY EXP MMIDDNYYY LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE X ,OCCUR _ PPK1644970 5/1/2017 5/1/2018 EACH OCCURRENCE $1,000,000 GET61�E PREMISES Ea occurrence $100,000 $5,000 MED EXP (An one person) PERSONAL & ADV INJURY $1,000,000 GENT AGGREGATE LIMIT APPLIES PER: POLICY a jE o LOC OTHER: GENERALAGGREGATE _ $2,000,000 PRODUCTS - COMP/OP AGG $2,000,000 $ AUTOMOBILE LIABILITY ANY AUTO ALL OWNED SCHEDULED AUTOS HIRED AUTOS X NON -OWNED AUTOS PHPK1645310 5/1/2017 5/1/2018 Ea accident $1,000,000 X BODILY INJURY (Per person) $ BODILY INJURY (Per accdent) $1,000,000 $ — X Per accident Comp/Coll Deductible $1,000 A X UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE PUB581572 5/1/2017 5/1/201B EACH OCCURRENCE $10,000,000 X AGGREGATE $ i DED RETENTION $ $ B WORKERS COMPENSATION �ANDEMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? ❑N (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below NIA WC2-Z91-462479-017 5/112017 5/1/2018 X PER OTH- STATUTE ER E. L. EH ACCIDENT $1,000,000 --AC E.L. DISEASE - EA EMPLOYE — $1,000,000 E.L. DISEASE -POLICY LIMIT $1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) BluSky Restoration Contractors, Inc. certifies that liability insurance in the amount of $1,000,000 that indemnifies the City against any and all loses that may arise from the use of the parking spaces per contract stipulations. GhK 111-IUA It HVLUtK GANGELLA I IUN City of Ft. Collins 215 N. Mason Street Ft. Collins CO 80537 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 © 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD