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HomeMy WebLinkAboutFOOTHILLS GUTTER & INSULATION DBA TELK SHEET METAL - INSURANCE CERTIFICATE (4)FOOTGUT-01 LJOHNSOP ACORO DATE (MM/DDIYYYY) �- CERTIFICATE OF LIABILITY INSURANCE 12/1/2016 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 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: PFS Insurance Group 4848 Thompson Parkway Suite 200 (AICNNo. Ext): (970) 635-9400 - -j,vc, No):(970) 635-9401 Johnstown, CO 80534oRss: inff�mypfsinsurance.com - 13021 INSURED INSURER B : Pinnacol Assurance Co _ 41190 Foothills Gutter & Insulation Inc INSURERC: Em loyers Mutual Casualty Company 21415 Talk Sheet Metal Works Inc dba _ PO Box 2156 INSURER D_------_--- -- Loveland, CO 80539 INSURER E : INSURER F : r11VC0Ar1_FC CI=DTICICATG NI IMRPD• RFVICI(1kl NI IMRFD- 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 TYPE OF INSURANCE 'ADDL.SU D POLICY NUMBER POLICY EFF POLICY EXP LIMITS LTRIN WV MMIDDIYYYY MM/D A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE OCCUR 0484429 12/05/2016 12/05/2017 DAMAGE TO RENTED PREMISES (Ea occurren 100,000 $ _ MED_EXP JAny.one rson $ 5,000 PERSONAL & ADV INJURY $ 1,000,000 GEN%AGGREGATE GENERAL AGGREGATE LIMIT APPLIES PER: POLICY j LOC $ 2,000,000 $ 2,000,000 PRODUCTS - COMP/OP AGG OTHER $ A 'AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1,000,000 ANY AUTO 60484429 12/05/2016 12/05/2017 BODILY INJURY Perperson) $_ OWNED SCHEDULED AUTOS ONLY X AUTOS BODILYBODILY INJURY Per accident _ $ _ P r a RTY accident) X AUTOS ONLY X ALTOS ONLDY $ — UMBRELLA LIAB OCCUR EXCESS LIAB CLAIMS -MADE EACH OCCURRENCE _$ $_- AGGREGATE DED RETENTION $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETORlPARTNER/EXECUTIVE C� EXCLUDED? J 1(�Mandatory n I We If yes, describe Under DESCRIPTION OF OPERATIONS below N / A 173269 12/01 /2016 12/01/2017 PER OTH- TATIZT E.L. EACH ACCIDENT 1,000,000 $ E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE - POLICY LIMIT $ 1,000,000 C Property, 5A06555 12/05/2015 12/05/2016 I BPP 25,500 DESCRIPTION OF OPERATIONS! LOCATIONS! VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) All locations/All operations If required by written contract or written agreement, the certificate holder is included as additional insured for ongoing operations. l:tK I It-II:A I t MULUtK trANC:tLLA I IUN Fort Collins Utilities Attn: Kaye Mathea P.O. Box 580 Fort Collins, CO 80522 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 potA 0. 7101e� ACORD 25 (2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD