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HomeMy WebLinkAboutD-7 ROOFING LLC - INSURANCE CERTIFICATE (2)ACORN® � CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 7/26/201e 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 Moody Insurance Agency, Inc. 8055 East Tufts Avenue Suite 1000 Denver CO 80237 CONTACT Deanna Zahn ACSR NAME: PHONiV Ex : AX (303)824-6600 Fir,lC No: (303)370-0118 ADDRESS: deanna. zahn@moodyins . com INSURE S AFFORDING COVERAGE NAIC # INSURERA:United Specialty Ins Co 12537 INSURED d-7 Roofing, LLC 5470 Lincoln St Denver CO 80216 INSURER B :American Select Insurance Co 19992 INSURERC:Evanston Ins Company 35378 INSURERD -Ar onaut Insurance Com an 19801 INSURER E :_ INSURER F : COVERAGES CERTIFICATE NUMBER:18-19 No Forms 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 OF INSURANCE ADDLTYPE INSD SUER POLICY NUMBER MMLICY EFF MM DDPOLICY EXP LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A CLAIMS -MADE X OCCUR A AGE TO NTED PREMISES Ea occurrence $ 100,000 MED EXP (Any one person) $ 10,000 X ATRATL1881441 8/1/2018 8/1/2019 PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY Fx_1 jE O LOC $ 2,000,000 PRODUCTS - COMP/OP AGG $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ 1,000,000 BODILY INJURY (Per person) $ X ANY AUTO B BODILY INJURY (Per accident) $ ALL OWNED SCHEDULED AUTOS AUTOS CAM4984006 8/1/2018 8/1/2019 PROPERTY DAMAGE Per accident $ NON -OWNED X X HIRED AUTOS AUTOS UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 5,000,000 X AGGREGATE $ 5 000 000 C EXCESS LIAB CLAIMS -MADE DED I X I RETENTION 0 $ IOMV7EUL100300 8/1/2018 8/1/2019 WORKERS COMPENSATION X PER OTH- STATUTE ER AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $ 1,000,000 D OFFICERIMEMBER EXCLUDED? ❑ (Mandatory in NH) N I A WC928418416284 8/1/2018 8/1/2019 E.L. DISEASE - EA EMPLOYE $ 1 000 000 I $ 1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space is required) Project: Mail Creek City of Fort Collins and Richmond American Homes are included as additional insured as respects General Liability when required by written contract. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Fort Collins THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN P.O. Box 580 ACCORDANCE WITH THE POLICY PROVISIONS. Fort Collins, CO 80522 AUTHORIZED REPRESENTATIVE D Zahn, ACSR/DANFLI ACORD 25 (2014/01) INS025 (201401) ©1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD