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Home My WebLink AboutHORIZON WEST BUILDERS - INSURANCE CERTIFICATE (6)HORIWES-01 DDAVIS AcoRo CERTIFICATE OF LIABILITY INSURANCE FDATE(MM/DD/YYYY) �--� 03/27/2017 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 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 Diane Davis NAME: Forsberg Engerman Co PHONE FAX 3575 S Sherman St (A/C, No, Ext): (303) 762-1717 (A/C, No):(303) 762-1733 Englewood, CO 80113 UMDRIEss: 4E,IV INSURED INSURER B : Pinnacol Assurance 41190 Horizon West Builders INSURERC: 3855 E 151st Ave INSURER 0: Brighton, CO 80602-7787 INSURER E INSURER F : d%^%1=OAnc:0 f`CDTIC1t ATC h111RA92FO• RF\/ICIn AI All IRARr-P- 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 SUBIR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE N POLICY NUMBER, M / /YYYY MM/DD/YY LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED REM( occurrence 100,000 $ 5,000 X CLAIMS -MADE X OCCUR Includes XCU )( D20448 04/01/2017 04/01/2018 MED EXP An one person)$ PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: X j LOC POLICY ❑ GENERAL AGGREGATE $ 2,000,000 PRODUCTS -COMP/OP AGG $ 2,000,000 OTHER: A AUTOMOBILE LIABILITY COMBIccNED SINGLE LIMIT a aident 1,000,000 $ BODILY INJURY Perperson) $ X ANY AUTO X E20448 04/01/2017 04/01/2018 BODILY INJURY Per accident OWNED SCHEDULED AUTOS ONLY AUTOS X HIRED X NON-Oy/ryLY AUTOS ONLY AUTOS ONLY $ $ -- — PeOacEctlT� AMAGE A X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 3000,000 EXCESS LIAB CLAIMS -MADE 20448 04/01/2017 04/01/2018 AGGREGATE $ 3,000,000 DED I I RETENTION $ B WORKERS COMPENSATION X I PERTUTE X OTH- ER AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ OFFICER/MEMBER EXCLUDED? (Mandatory in NH) N/A 4088363 01/01/2017 01/01/2018 E.L. EACH ACCIDENT 1,000,000 $ E.L. DISEASE - EA EMPLOYE 1,000,000 $ E.L. DISEASE - POLICY LIMIT _ 1,000,000 $ If yes, describe under DESCRIPTION OF OPERATIONS below A Inland Marine 4C20448 04/01/2017 04/01/2018 Leased/Rented Equip 25,000 A (Scheduled Equipment I 4C20448 04/01/2017 04/01/2018 Limit 152,211 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space is required) Certificate holder is additional insured with respect to general liability and automobile liability coverage. f`AAIf`CI I ATInAI SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE The City Of Ft Collins Y THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Purchasing Department PO Box 580 Ft Collins, CO 80522-0580 AUTHORIZED REPRESENTATIVE ACORD 25 (2016/03) U 19BB-2015 AGUKU GUKNUKA I IUN. An rlgnis reservea. The ACORD name and logo are registered marks of ACORD