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HomeMy WebLinkAboutUpdated Insurance.pdf ACORD CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 10/29/2015 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 AAI -Mike Neff Insurance Agency PHONE Debbie Harland T FX PO BOX 3289 (A/CA Lo.Ext1: 970-949-5633 I IANC,No):970-949-0691 Avon, CO 81620 AEDDRESS: dharland@insuranceaai.com License#: RPA195613 INSURER(S)AFFORDING COVERAGE NAIC# INSURER A: Gemini Insurance Company INSURED INSURERB: Travelers 19046 Foster Construction Ltd INSURERC: Commercial-Pinnacol Brad Foster PO Box 1952 INSURER D Edwards, CO 81632 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 00000000-165025 REVISION NUMBER: 2 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. 1LTRR TYPE OF INSURANCE INSD SUBR WVD POLICY NUMBER IMMIDDY/YEYYY) (POLICY M/LDD YY) LIMITS A X COMMERCIAL GENERAL LIABILITY Y VCGP 050171 10/01/2015 10/01/2016 EACH OCCURRENCE $ 1,000,000 DAMAGE TO D CLAIMS-MADE X OCCUR PREMISES Ea occurrence) $ 50,000 MED EXP(Any one person) $ 5,000 PERSONAL 8 ADV INJURY $ 1,000,000 GE 'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE S 2,000,000 X POLICY jECT LOC PRODUCTS-COMP/OPAGG S 2,000,000 OTHER: $ B AUTOMOBILE LIABILITY BA6921R420 09/15/2015 09/15/2016 Ea accidentCOMBIND SINGLE LIMIT $ 1,000.000 ANY AUTO BODILY INJURY(Per person) S ALL OWNEDSCHEDULED BODILY INJURY(Per accident) S AUTOS X AUTOS NON-OWNED PROPERTY DAMAGE X HIRED AUTOS X AUTOS (Per accident) $ UMBRELLA LIAB _ OCCUR EACH OCCURRENCE S EXCESS LIAB CLAIMS-MADE AGGREGATE S DED RETENTIONS S WORKERS COMPENSATION PER OTH C AND EMPLOYERS'LIABILITY YIN 4142575 11/01/2015 11/01/2016 X STATUTE ER ANY PROPRIETORIPARTNERJEXECUTIVE E L EACH ACCIDENT $ 500,000 OFFICER/MEMBER EXCLUDED? Y N/A (Mandatory in NH) E L DISEASE-EA EMPLOYEE 500,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT 5 500,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101 Additional Remarks Schedule.may be attached If more space Is required) Project: Manor Vail#A212 renovation Manor Vail and Ellen Lautenberg are additional insured's under the General Liability policy as required by written contract. CERTIFICATE HOLDER CANCELLATION Manor Vail SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN Ellen Lautenberg ACCORDANCE WITH THE POLICY PROVISIONS. 595 E Vail Valley Dr Vail CO 81657 AUTHORIZED REPRESENTAT 4 4 (DSH) ©1988-2014 ACORD CORPORATION. Allots reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD Printed by DSH on October 29,2015 at 04:43PM AcG CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 10/29/2015 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 AAI-Mike Neff Insurance Agency PHONE Debbie Harland FAX PO Box 3289 allo.ExtI: 970-949-5633 (A/c,No):970-949-0691 IL Avon,CO 81620 ADDRESS: dharland@insuranceaai.com License#: RPA195613 INSURER(S)AFFORDING COVERAGE NAIC# INSURERA: Gemini Insurance Company INSURED INSURERB: Travelers 19046 Foster Construction Ltd INSURERC: Commercial -Pinnacol Brad Foster PO Box 1952 INSURER D Edwards, CO 81632 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 00000000-167846 REVISION NUMBER: 2 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 TYPE OF INSURANCE ADDL SUER POLICY EFF POLICY EXP LIMITS LTR INSD WVD POLICY NUMBER IMM/DD/YYYY) IMM/DD/YYYY) A X COMMERCIAL GENERALLIABILITY Y VCGP 050171 10/01/2015 10/01/2016 EACH OCCURRENCE $ 1,000,000 DAMAGE TO D CLAIMS-MADE X OCCUR PREMISES Ea occurrence) $ 50,000 MED EXP(My one person) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $ 2,000,000 X POLICY JECT LOC PRODUCTS-COMP/OPAGG $ 2,000,000 OTHER: $ B AUTOMOBILE LIABILITY BA6921 R420 09/15/2015 09/15/2016 Ee acclldeDtSINGLE LIMIT $ 1.000.000 ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Perident) $ AUTOS X AUTOS accident) _ X HIRED AUTOS ANON-OWNED PROPERTY DAMAGE _ AUTOS (Per accident) $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ S WORKERS COMPENSATION ;MUTE 4142575 11/01/2015 11/01/2016 X STATUTE ER AND EMPLOYERS'LIABILITY OFFICER/MEMBERPEXCLUDED?ARTNER/EXECUTIVE Ri N/AANY E.L.EACH ACCIDENT S 500,000 R (Mandatory In NH) I T I E.L.DISEASE-EA EMPLOYEE $ 500,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached H more space Is required) Project: Manor Vail#348 renovation Manor Vail and Frison Family LLC are additional insured's under the General Liabiltiy policy as required by written contract. CERTIFICATE HOLDER CANCELLATION Manor Vail SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN Frison Family LLC ACCORDANCE WITH THE POLICY PROVISIONS. 595 E Vail Valley Dr Vail CO 81657 AUTHORIZED REPRESENTA E I (DSH) ©1988- 014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD Printed by DSH on October 29,2015 at 04:43PM