Loading...
HomeMy WebLinkAboutMP CONTRACTING LLC - INSURANCE CERTIFICATE (2)MPCONTR-01 MSWAIM ACORN YY) ID (MMD/YY �,� CERTIFICATE OF LIABILITY INSURANCE 0DATE (MM/ DfYY 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 NAME: Forsberg Engerman Co Fors S Sherman a PHONE A/CC, No, Ext): (303) 762-1717 jac, No):(303) 762-1733 AIL Englewood, CO 80113 ADDRESS: W-1 INSURED INSURER B: EMC Insurance Companies 21415 MP Contracting LLC INSURER c : Pinnacol Assurance 41190 550 E 64th Ave INSURER D : Denver, CO 80229 INSURER E INSURER F : t117=1CIP1ATC \111ea131=113. DGVICIr%KI All IMRFD- 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 LTRA TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE � OCCUR EF4ML02392-171 11/03/2017 11/03/2018 EACH OCCURRENCE $ 1,000,000 DAMAGE _ a oTO ccurrence) $ 110,000 MED EXP An one person)$ PERSONAL & ADV INJURY 00,000 $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY 1 PEC LOC OTHER: GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP/OP AGG $ 2,000,000 $ 2,000,000 POLLUTION AGG B AUTOMOBILE LIABILITY X ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS X AUTOS ONLY X NON-OWNED ONLY 4E63082 11/03/2017 11/03/2018 COMBINED SINGLE LIMIT Ea_a_ccident 1,000,000 $ _ $ BODILY INJURY Perperson) BODILY INJURY Per accident $ PROPERTYDAMAGEGE $ A X UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE EF4C000389-171 11/03/2017 11/03/2018 EACH OCCURRENCE $ 5,000,000 AGGREGATE $ 5,000,000 DED X RETENTION $ 10,000 C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY y/ N ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N/A 4082297 07/01/2018 07/01/2019 X PER OTH- T T TE ER E.L. EACH ACCIDENT 1,000,000 $ _ 1,000,000 $ E.L. DISEASE - EA EMPLOYEE E.L. DISEASE - POLICY LIMIT _ 1,000,000 $ A B Pollution Inland Marine EF4ML02392-171 4C63082 11/03/2017 11/03/2017 11/03/2018 11/03/2018 Aggregate Leased/Rented 2,000,000 200,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) CERTIFICATE HOLDER L:ANL:tLLA I IUN SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Ft. Collins THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ty ACCORDANCE WITH THE POLICY PROVISIONS. 256 W. Mountain Avenue Ft. Collins, CO 80522 AUTHORIZED REPRESENTATIVE ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD