HomeMy WebLinkAboutBUILDERS BY DESIGN LLC - INSURANCE CERTIFICATEA�^� ® DATE (MMIDD/YYYY)
1111.�C" CERTIFICATE OF LIABILITY INSURANCE F9/20/2017
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 riqhts to the certificate holder in lieu of such endorsement(s).
PRODUCER
Commercial Risk Solutions
6600 E Hampden Ave Ste 200
Denver CO
INSURED
Buildings By Design, LLC.
18163 Count Road 26
Brush CO 80723
BUILD-6
NAME... Scott Anderson, CIC
P"(A/c NN Ezt). 303-996-7833 mac, No), 303-757-7719
E-MAIL sanderson@crsdenver.com
ADDRESS: _ _-
INSURER(S) AFFORDING COVERAGE NAIC 1
INSURERA:Westfleld Insurance 24112
INSURER B : Pinnacol Assurance 41190
INSURER C :
ER F :
rnt/FDAnr1z r_FDTICIr`ATC 11u IRROCD. 1 Qdn6R4Q6Q DGtnclnrll w Iaa01170.
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.
ILTIRNSR TYPE OF INSURANCE I POLICY NUMBER MMIDDIPOLICY EX
YYFF MMIDD/YYYY LIMITS
A
X
COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE ❑X OCCUR
Y
TRA3658080
2/10/2017
2/10/2018
EACH OCCURRENCE
$1,000,000
_
ANfAGETOI7ENTE�
PREMISES Ea occurrence
E500,000
MEDEXP(Anyone
$5,000
_
_person)
PERSONAL & ADV INJURY
$1,000,000
AGGREGATE LIMIT APPLIES PER:
POLICY JEC LOC
GENERAL_ AGGREGATE
$2,000,000
GEN'L
PRODUCTS - COMP/OP AGG
E2,000,000
E
OTHER:
A
AUTOMOBILE
LIABILITY
Y
TRA3658080
2/10/2017
2/10/2018
uMI31NEI) SINGLE LIMIT
accideTJ
$1,000,000
X
_
BODILY INJURY (Per person)
$
ANY AUTO
OWNED ASCHEDULED
AUTOS ONLY UTOS
BODILY INJURY (Per accident)
E
HIRED NON OWNED
AUTOS ONLY X AUTOS ONLY
X
6PERT1'1SAt XGE
Peraccident)`T_
$
Broadened Pollution
$Included
A
X
UMBRELLA LIAB
X
OCCUR
TRA3658080
2/10/2017
2/10/2018
EACH OCCURRENCE
$5,000,000
AGGREGATE
$5,000,000
EXCESS LIAB
CLAIMS -MADE
DED X RETENTION$0
$
B
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY YIN
ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICER/MEMBER EXCLUDED?
NIA
4073732
10/1/2017
10/1/2018
X PERT ERH
E.L. EACH ACCIDENT
$500,000
E.L. DISEASE - EA EMPLOYE
—"_--
$500,000
(Mandatory in NH)
If yes, describe under
DESCRIPTION OF OPERATIONS below
$500'000
E.L. DISEASE -POLICY LIMIT
A
i
Inland Marine
EquipmenVACV/Special
TRA3658080 2/10/2017
2/10/2018
Rent/Leased t,0,000
Deductible 500
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
The City of Fort Collins, its officers, agents and employees included as additional insured for ongoing operations on the General Liability and
included as additional insured on the Auto Liability with respect to operations of the named insured for the certificate holder as required by
written contract. All policy terms, conditions and exclusions apply.
CERTIFICATE HOLDER CANCELLATION
City of Fort Collins Financial Services Purchasing
Division
215 N Mason Street 2nd Floor
Ft. 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
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ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD