HomeMy WebLinkAboutCAPITAL ROOFING INC - INSURANCE CERTIFICATE 2023-2024�1
A`ORO
caP�Roo-o�
CERTIFlCATE OF LIABILITY INSURANCE
DATE�MMI�DIYYYY�
THIS CERTIFICATE IS 15SUED AS A MATTER OF INFORMATION ONLY AhD CONFERS NO RIGHT5 UPON THE CERTIFICATE HOLDER. THIS
CERTIFfCATE DOES hOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICAT� OF INSURANCE DOES NOT CONSTITUTE A CONTRAGT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
RERRESENTATIVE OR PRODUCER, AND THE CERTI�ICATE HOLDER.
IMPORTANT: If the certiflcate holder is an ADDITIONAL INSURED, the poficy(ies� must have ADDITIONAL INSl1RE0 provisions or be endorsed.
If SUBROGATION 13 WAIVED, subject to the terms and conditlons of the pollcy, certain pollcies may require an endorsement. A statement on
this certificate does not confer rfahts to the certificate holder in Ifeu of such endorsementlsl.
PRDUUCER �wQ���a ,r w.�
HUB International Mountain States Limlted
9620 E Pershing Blvd, Suite 100
Che�enne, WY 82001
iNsuReo
Capitol Roofing, Inc
805 E. Fox Farm Road
Cheyenne, WY 82007
$32-6420
632-6447
COVERAGES CERTIFICATE NUMBER: REVISION Nl1MBER:
THIS IS TQ CERTIFY THAT THE POLIGIES QF INSURANCE LISTE� SELOW HAVE BEEN ISSUE� TO THE INSUREd NAMED ABOVE FQR THE POLICY PERIOD
INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT W1TH RESPECT TO WHICH THIS
C�RTIFICA7� MAY BE ISSU�D OR MAY PER7AIN, 7HE INSURAMCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
�XCLUSIONS AN� CONDkTIpNS OF SUCH POLIGIES. LfMITS SHpWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
IN5R TypE OF INSURANCE A�DL SUBR ppLICY Ni1MB6R P��-�Y �FF POLICY E%P LIMITS
A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE S �,OOO,OOO
CiAIMS-MADE X OCCUR CSU0208439 5I912D23 $f�f2�Z4 DAMAGE TO RENTEO ; � 00,00D
ME� EXP M one rson $ Excluded
PERSONAL & A�H INJURY ; � �O�D,oao
GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE S 2�OUO,OOD
POLICY � j�� � LOG PROolICTS-COMPlOPAGG S 2�ODO,OOO
orHeR: WY STOA GAP S 1,OD0,000
8 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT S 'I,ppO,DOO
X ANYAUTO BX03717 $JiI�O2S $IiIZO24 BO�ILYINJURY Per S
01FMED SCHEOULEO
AUTOSONLY AUTOS BO�]LYINJURY PeraccideM 5
AUTOS ONLY A0T4� ONLY �� a�e� AMAGE 5
5
�+ UMBRELLA LIAB X OCCUR EACH OCCURRENCE S 2�DOO,OQO
X HXCESS LIRB CIAIMS�AA�E BE 031374528 �S1112023 51112024 AGGREGATE S 2,���,���
DEO RETENTION S
WORKERS COMPEN$ATON PER OTH-
AN➢EMPLOYERS'LIABII,ITY YjN
aFfICER1pINRE�NITBOERR EXCLUOE�? ECU71�E � N f A E.L. EACH ACCIOENT S
�ulandatory In NH) E.L. DISEASE - EA EMPLOYE S
IE yes, descri6e unde�
DESCRIPTION Of OPERATIONS below E.L �ISEASE - POLICY LIM4T S
OESCRIPiION OF OPERATONS f LOCATIONS! VEHICLES {ACORD 101, Addltional Remarks Schedule, may ba attachad H more apace is required)
City pf Fort ColUns
2$1 North Coliege Ave
PO Boz 580
Fort Collins, CO 8D522
SHOUL� ANY OF THE A90VE �ESCRI6fD PQLICIES BE CANCELLED BEFpRE
THE EXPIRATfON DATE THEREOF, NOTIC� WILL BE qEE.IVEREp IN
ACCDRDANCE WITH iHE POLICY PROVISIONS.
AU7HORI2ED REPRESENTAiNE
/�'�L�._
ACORD 25 (201BI03j O 1988-2D15 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACOR[]