HomeMy WebLinkAboutFRANKCRUM 1 INC - INSURANCE CERTIFICATE 2023-2024�!�v � CERTIFICATE OF LIABILITY INSURANCE
DATE (MMfD�NYYY)
05/11/2023
THIS CER7IFICA7� 15 ISSUEn AS A MATTER OF INFORMATI4N ONLY ANI] CONF�RS NO R1GH7S UPON 7HE CER7IFICATE HQLDER. TNIS
CERTIFlCATE �OES NOT AFFIRMATIVELY OR NEGATIYELY AMEND, EXTEND OR ALTER FHE COVERAGE AFFORO£D BY THE POLICIES
�ELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITU7E A CONTRACT BETWEEN THE ISSUING INSUR�R(5j, AUTHORIZ�D
REPRESENTATIVE OR PRODUCER, AN� THE CERTIFICATE HOLDER.
IMPOiiTANF: If the certificate holder is an AaDITiONAL lNSURED, the policy(ies) must have ADDITIOIJAL INSURED provisions or be endorsed.
If SUBROGATIOiJ 15 WAIVED, su6ject to the terma and cpnditians of the poiicy, certain policies may require an endorsement. A statement on
this certificate does not confer rft�hts to the certiflcate holder in Ifeu of such endorsementlsl.
F'q00UCER
Bouchard Insurance for FrankCrum
iQ1 Starcrest Drive
Clearwater, FL 33758
INSURED
FrankCrum 1, Inc. AN. Emp: Rite Hand Consiruclian, Inc
10D South Mlssourl Avenue
Clearwater, FL 33756
COVERAGES CERTIFICATE NUMBER:23FL080818187 REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE Lt5TE0 BELOW HAVE BEEN ISSUE� TO THE IIVSURED iVAMED ABOVE FOR THE POLICY PERfOD
INDECATED. N07WITHS7ANDING ANY RE�UIREMENT, TERM �R CONDITION OP ANY CON7FiACT OR O7HER DOCUMEN7 WI7H F2E5PEC7 TO WHICH TNIS
CERTIFICAiE MAY BE ISSUED OR MAY PERTAIN, 7HE INSURANCE AFFORI7ED BY THE POl.ICIES DESCRIBED HER81N IS SUBJECT TO R�L THE TERMS,
EXCWSIONS AN� CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN RED[10E� 6Y PAID CLAIMS.
INSR isDlSL U�F POUCY EFF POLICY EXP
7q TYPE OF INSURANCE POLICY NUMBER MMfDDII'YYY MMl�OlYYYY LIMITS
GOMMERCIAI,GEM�RqLlIA81l,ITY EACHOCCURRENCE $
CLAIMS•MA�E � 4CCl1R pREM{A SES E�a ��urr�e�ce 5
MED FX? (Any ane person} $
PERSONAL 8 AOV INJURY $
GEN L AGGREGATE LIMIT APPLIES PER: GENERAt AGGREGATE S
P041CY ❑ jE C � � LOC PROpUCTS - COMPlOP AGG S
OTHER: S
AUTOMOBlLELIABILITY OM6INED INGLELIMIT §
Ea acddenl
ANY AUTO BOOILY INJURY (Per person► $
OWNEp SCFiEDULEp gpp�LY INJURY SPer atudeniy S
AUTOS ONLY AUTOS
HIRED NON-OWNEO PROPERTY UAMAGE �
AUTOS ONLY AUTOS OMLY Per eccidenl
$
11MBRELLALIAB OCCUR EAC310CCURRENCE $
E%CESS LIAB CLAIMS-MAOE AGGREGATE 5
OE❑ RETENTIONS 5
WORKERS COMPENSATIOH X
AND £MPLOYERS' LIABILITY STATUTE ER �
ANYPROPRIEiOR7PARTNERlEXECUFwE Y 1 N E.E. EACH ACCI�ENF S 1,000 OOO
A OFFICEWMEMBEREXCiU�EO? � NIA WC47-58-512=12 46141f2423 46/01/2024
�Mantlsiory In NHj E.L. L�iSEASE - EA EMPLOYEE� 5 1,OQ4,000
II yes, desulbe under I
OESCRIPTION OF OPERATIONS balow E.� . GISEASE • POLICY LIMIT 1$ 1,OQO,OOO
I.Ocaiion Coverage Period: 061D1�023 a6/01l2024 Clfent# 10879-CO
OESCRlPTION OF OPERATIONS 1 LOCATION91 YEHICLES (ACORDl01 AtldfUonal Ramerks Sthedule may be attachetl �I more �pace Ia raqulretl)
Covarage is provided ror Rita Hand Construction, Inc
only those co-employees � 35 8�h S�
of, but not subcontracrors C.tireeley, CO 80631
to:
TE
City of Fort Coliins
281 N. College
Fort Collins, CO 80521-528
ELE.ATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES 8E CANCELLEa BEFORE
TNE EXPIRATION DATE THEREOF, NOTICE WILL BE �ELIVERE� IN
ACCORDANCE W17H TIiE POLICY PRdVISIONS.
At1THORIZEO REPRESENTATIVE
� �
ACORD 25 (2016l03)
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