Loading...
HomeMy WebLinkAboutCANYON MECHANICAL INC - INSURANCE CERTIFICATE (9)A�� �® CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 9/29/2016 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 CONTACT Javier Perez NAME: PHONE (970)356-0123 A/C No:FAX (970)330-1867 Flood and Peterson MAILADDRESS: JPerez@F1oodPeterson.com E-MAIL-ADDRESS: PO Box 578 INSURER(S) AFFORDING COVERAGE NAIC # INSURERA:Ohio Casualty Insurance Company 24074 Greeley CO 80632 INSURED INSURER B :Peerless Indemnity Insurance 18333 INSURERC:Pinnacol Assurance 41190 Canyon Mechanical, Inc. INSURER D : P O Box 327 INSURER E : INSURER F : Berthoud CO 80513 COVERAGES CERTIFICATE NUMBER:CL1692913673 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 I LTR TYPE OF INSURANCE IN UBR POLICY NUMBER ' MM/ICY EFF DD/YYYY FOLIC EXP LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A —1 CLAIMS -MADE � OCCUR DAMAGE ToRENTED PREMISES E. occurrence $ 300,000 MED EXP (Any one person) $ 15,000 BKS1555648252 10/14/2016 10/14/2017 PERSONAL BADVINJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY � PE0 E LOC PRODUCTS - COMP/OP AGG $ 2,000,000 $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ 1,000,000 BODILY INJURY (Per person) $ B X ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS BA2019911 10/14/2016 10/14/2017 BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per acc dent $ NON -OWNED X HIRED AUTOS X AUTOS Medical payments $ 5,000 UM13RELLALIAB OCCUR EACH OCCURRENCE $ HCLAIMS-MADE AGGREGATE $ EXCESS LIAB DED RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N X PER OTH- STATUTE I I ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $ 100,000 C(Mandatory in NH EXCLUDED? ❑ ' ) NIA 4001984 6/1/2017 6/1/2018 E.L. DISEASE - EA EMPLOYEq $ 100,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION City of Fort Attn: Delynn P O Box 580 Fort Collins, 1 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Collins Building and Zoning THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. CO 80522-0580 I AUTHORIZED REPRESENTATIVE ACORD 25 (2014/01) INS025 12n140n Javier Perez/JPEREZ ©1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD