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Home My WebLink About453145 INDEPENDENT ROOFING INC - INSURANCE CERTIFICATE (10)ACORD,M CERTIFICATE OF LIABILITY INSURANCE DATE(MM0/2017YY) o, n o/zo, 7 PRODUCER nna PinnacolAssurance THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY 7501 E Lowry Blvd AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS Denver, CO 80230-7006 CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE NAIC# INSURED INSURERA: Pinnacol Assurance 41190 Independent Roofing Inc 405 22nd Street Greeley, CO 80631 INSURER B: INSURER C: INSURER D: INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDNG ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE 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 ADD'L POLICY EFFECTIVE POLICY EXPIRATION LTR INSRD TYPE OF INSURANCE POLICY NUMBER DATE(MM/DD/YYYY) DATE(MMIDD/YYYY) LIMITS GENERAL LIABILITY EACH OCCURRENCE DAMAGE TO RENTED COMMERCIAL GENERAL LIABILITY CLAIMS MADE OCCUR PREMISES MED EXP(Any one Person PERSONAL d ADV INJURY GEN'L AGGREGATE LIMIT APPLIERS PER: GENERAL AGGREGATE PRODUCTS - COMP/OP AGG 17 POLICY F1 PROJECT LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT ANY AUTO Ea Accident) BODILY INJURY ALL OWNED AUTOS SCHEDULED AUTOS (Per person) BODILY INJURY HIRED AUTOS - NON -OWNED AUTOS Per accident PROPERTY DAMAGE (Per accident) . GARAGE LIABILITY - AUTO ONLY - EA ACCIDENT OTHER THAN EA ACC ANY AUTO - AUTO ONLY: AG EXCESSIUMBRELLA LIABILITY EACH OCCURRENCE OCCUR CLAIMS MADE AGGREGATE DEDUCTIBLE RETENTION $ WORKERS COMPENSATION AND WC STATU- OTHER A EMPLOYERS LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE 866470 01 /01 /2017 01 /01 /2018 LIMITS E.L.L EACH ACCIDENT $1,000,000 E.L DISEASE - EA EMPLOYEE $1,000,000 OFFICER/MEMBER EXCLUDED? If yes, please describe under SPECIAL PROVISIONS below E.L DISEASE- POLICY LIMIT 1 D00 000 OT ER DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLESIEXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION 1763962 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Fort Collins PO Box 580 Fort Collins, CO 80522-0580 THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO NOTIFY 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO NOTIFY SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE Joseph Rutigliano ACORD 25(2001/08) Underwriter ACORD CORPORATION 1988 CERTIFICATE HOLDER COPY City of Fort Collins PO Box 580 Fort Collins, CO 80522-0580 IMPORTANT If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). 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). DISCLAIMER The Certificate of Insurance on the reverse side of this form does not constitute a contract between the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon.