HomeMy WebLinkAbout399198 FRONT RANGE ROOFING SYSTEMS LLC - INSURANCE CERTIFICATE (9)7427/2017
(MM/DD/YYYY)
A�" CERTIFICATE OF LIABILITY INSURANCE
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 Valerie Love, CIC, CISR
NAME:
FAX
Flood and Peterson IA/CC,%Ex0• (97D)SD6-3215 A/C.No:(970)506-6865
PO Box 578 E-MAIL VLove@F1oodPeterson.com
ADDRESS:
Greeley, CO 80632 INSURER(S)AFFORDING COVERAGE NAIC#
INSURERA:The Continental Insurance Company 35289
INSURED INSURERB:Continental Casualty Company 20443
Front Range Roofing Systems, LLC INSURERC:Pinnacol Assurance 41190
222 13th Ave INSURERD:National Fire Insurance Co 20478
Greeley, CO 80631 INSURER E:Ameri can Casualty Company
INSURER F
rnvconr_cc f`C0T1CIr`ATC AIIIMRGR•2017 - 2018 RFVICInN NIIMRFR-
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 ADDL SUBR POLICY EFF POLICY EXP I LIMITS
LTR TYPE OF INSURANCE POLICY NUMBER MM/DDNYYY MM/DDNYYY
$
COMMERCIAL GENERAL LIABILITY
EACH OCCURRENCE
$ 1,000,000
�X
300,000
A
CLAIMS -MADE OCCUR
PREM SESOEaoccurrence
$
MED EXP (Any one person)
$ 10,000
6046127324
5/1/2017
5/1/2018
PERSONAL & ADV INJURY
$ 1,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
GENERAL AGGREGATE
$ 2,000,000
PRODUCTS - COMP/OPAGG
$ 2,000,000
~, F_-7 P O
POLICY LOC
$
OTHER:
AUTOMOBILE LIABILITY
COEa acMBINED SINGLE LIMIT cident
$ 1,000,000
BODILY INJURY (Per person)
$
X ANY AUTO
A
ALL OWNED SCHEDULED
6046127310
5/1/2017
5/1/2018
BODILY INJURY (Per accident)
$
AUTOS
X X NON -OWNED
$
PROPERTY DAMAGE
Per accident
HIJREDSAUTOS AUTOS
-
X I UMBRELLA LIAB
X
OCCUR
EACH OCCURRENCE
$ 5,000,000
AGGREGATE
$ 5,000,000
B
EXCESS LIAR
CLAIMS -MADE
CUE6049565482
5/1/2017
5/1/2018
DED I X 1 RETENTION$ 10,000
$
C WORKERS COMPENSATION
1946560
6/1/2016
6/1/2017
77 PER
STATUTE ER
AND EMPLOYERS' LIABILITY YIN
PROPRIETOR/PARTNER/EXECUTIVE
E.L. EACH ACCIDENT
$ 1,000,000
,OFFICER/MEMBER EXCLUDED?
E (Mandatory in NH)
N/A
6046127307
6/1/2017
5/1/2018
E.L. DISEASE - EA EMPLOYEE
$ 1,000,000
If YYes. describe under
DESCRIPTION OF OPERATIONS below
E.L. DISEASE - POLICY LIMIT
$ 1,000,000
D Property/Inland Marine
6046449378
5/1/2017
5/1/2018
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
City of Fort Collins is named as Additional Insured.
!`COTICH'ATC W11 1111=0 rANrFI I ATInN
I
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLEDBEFORE
City of Fort Collins
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVJRED IN
P. 0. BOX 580
ACCORDANCE WITH THE POLICY PROVISIONS.
Fort Collins, CO 80522-0000
AUTHORIZED REPRESENTATIVE
V Love, CIC, CISR/VLO
U 1988-2014 AGUHU GUHNUHA I IUN. All rlgnts reservea.
ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD
INS025 (201401)