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HomeMy WebLinkAboutCANYON MECHANICAL INC - INSURANCE CERTIFICATE (10)/ 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 Flood and Peterson PO Box 578 Greeley CO 80632 CONTACT Javier Perez NAME: PHONE (970)356-0123 FAX No:(970)330-1867 MAILADDRESS: JPerez@F1oodPeterson.com E-MAIL-ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # INSURERA Ohio Casualty Insurance Company 24074 INSURED Canyon Mechanical, Inc. P O Box 327 Berthoud CO 80513 INSURER B :Peerless Indemnity Insurance 18333 INSURERC:Pinnacol Assurance 41190 INSURER D : INSURER E : INSURERF: 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 LTR TYPE OF INSURANCE I L UBR POLICY NUMBER M DDIYYYY XP MM/DD/YYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A CLAIMS -MADE ❑X OCCUR DAMAGE TO R PREM SES Ea occu ante $ 300 , 000 MED EXP (Any one person) $ 15,000 BKS1555648252 10/14/2016 10/14/2017 PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY JECT1:1 LOC PRODUCTS - COMP/OP AGG $ 2,000,000 $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea ccident a $ 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 accident $ NON -OWNED X HIRED AUTOS X AUTOS Medical payments $ 5,000 UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DED RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y ANY PROPRIETOR/PARTNER/EXECUTIVE PER OTH- X STATUTE ER E.L. EACH ACCIDENT $ 100,000 C OFFICER/MEMBER EXCLUDED? ❑ (Mandatory in NH) N/A 4001984 6/1/2017 6/1/2018 E.L. DISEASE - EA EMPLOYEE $ 100,000 If yes, describa 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) 1101:11:41912 W_rl=1:Lei 14 City of Fort Collins PO Box 580 Fort Collins, CO 80522-0000 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 ACORD 26 (2014/01) INS025 12014011 Javier Perez/JPEREZ ©1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD