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Home My WebLink About330878 SIMPSON & SIMPSON SALES & SERVICE INC - INSURANCE CERTIFICATE (8)ACC>R" CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DDNYYY) 8/25/2017 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 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: PHONE No,Ext : 03- 67-2055 A/c No):303-867-2074 Olson &Olson Ltd 5655 S. Yosemite St. #101 Greenwood Village CO 80111 E-MAIL ADDREss:rh n h I n n I n. m INSURER(S) AFFORDING COVERAGE NAIC # INSURER A:W s fiel Insurance Com n 1 INSURED SIMPS-1 INSURER B:Pinnacol Assurance 41190 INSURERC: Simpson & Simpson Sales & Service, Inc. INSURERD: PO BOX 524 Broomfield CO 80038 INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: 572646144 REVISION NUMBER: 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 LTR TYPE OF INSURANCE ADDL INSR SUBR WVD POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DD/YYYY LIMITS A GENERAL LIABILITY CWP5452191 9/1/2017 9/1/2018 EACH OCCURRENCE $2,000,000 COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED PREMISES Ea occurrence $300,000 CLAIMS -MADE a OCCUR MED EXP (Any one person) $5,000 PERSONAL & ADV INJURY $2,000,000 GENERAL AGGREGATE $4,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $4,000,000 $ POLICY PRO LOC A AUTOMOBILE LIABILITYOMBINED CWP5452191 9/1/2017 9/1/2018 Ea accident SINGLEMI $1,000,000 X BODILY INJURY (Per person) $ ANY AUTO BODILY INJURY (Per accident) $ ALL OWNED SCHEDULED AUTOS AUTOS X PROPERTY DAMAGE Per accident $ NON -OWNED HIRED AUTOS X AUTOS A X UMBRELLA LIAB X OCCUR CWP5452191 9/1/2017 9/1/2018 EACH OCCURRENCE $2,000,000 AGGREGATE $2,000,000 EXCESS LIAB CLAIMS -MADE DED I X I RETENTION$0 $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? N (Mandatory In mi) N / A 4095690 9/1/2017 9/1/2018 X WC STATU- I OTH- T RY LIMIT S ER E.L. EACH ACCIDENT $1,000,000 E.L. DISEASE - EA EMPLOYEE $1,000,000 E.L. DISEASE - POLICY LIMIT $1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) Certificate Holder and those listed below(if any) are Additional Insureds as respects General Liability and Umbrella Liability on a Primary and Non -Contributory basis, and Auto Liability only if required by written contract or agreement and coverage applies only as respects work performed by the Insured for the Additional Insureds. All coverage terms, conditions, and exclusions of the policy apply. The Worker's Compensation, General Liability, Auto Liability, and Umbrella Liability policies include a Waiver of Subrogation in favor of the Additional Insureds only if required by written contract or agreement. Contract work. GLRTIFIGA I L HULDLK t AF4l r_LLA I IVN City of Fort Collins 300 LaPorte Ave 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 U 19BB-2010 ACORD GORI'ORA I ION. All rights reservea. ACORD 25 (2010/05) The ACORD name and logo -ire registered marks of ACORD