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HomeMy WebLinkAboutDRB17-0209_vaillicenseins_1496166180.pdf ti L,, TOWN OF VAIL . L./..)., CONTRACTOR REGISTRATION Tovy ��. 0 L� Brs;nex Warne: Windows Arrlelica of Colorado,Inc. �� �� PriReipa]Name: Clyde J.Lundeen �� �3Business Address: 455 115th Avenue#5 — — — — — — — u/�. City,State Zip: Denver,CO 80234 �.i� �� Phone: (303 920 -0175 ' 1�1� E-Mair: windowscolo@aol.com (♦ /\�- Electrical and Plumbing contractors shall provide their State of Colorado Electrical or Plumbing License number t[��/� } Fire Protection contractors shall provide of their Vail Fire and Emergency Services Contractor Registration number 0{ ' 0 Electrical Lie.t#; 0 VFES Contrecor Y Reg.#: _ ��. � � G Plumbing Lic.#: - 4� I hereby certify that it is my responsibility to abide by the Vail Town Code and licensing requirements.Further,I certify that I shall maintain the insurance and keens- 0L ing requirements per Vail Tosvn Code.I understand that failure to comply with all town codes,laws,and regulations may result in revocation of my license including � penalties as allowed by law. 1 � ::::::::2./ ___,„..1,, __oaf}, �% 3-r7�7 1 �_ � Contras or:rgnature Date Issued by:Florencio Mondragon,Acting Chief Building Official Date L.7%),' l Registration Expiration Datekl ] Cornumncty Development Department-7i South Frontage Read West—Vail,CO 81657—Phone:970-479-2139 AS RD0 CCERTIFICATE OF LIABILITY INSURANCE QA7E(MMIDDIYYYY) 3/17/2017 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 NAME: Fred Lautenbach Lautenbach Insurance Agency, LLC PHONE (303 798-2534 Fax IAIG.Np,Ext1: ) (AIC,Na): (303)798-2536 5721 S. Nevada Street E-MAIL MxREMfred@lautenbachinsurance.com Littleton, CO 80120 INSURER(S)AFFORDING COVERAGE NAIC# INsuRERA:Liberty Mutual Insurance Company INSURED INSURER B Windows America of Colorado, Inc. INSURER C: DEA New Windows for America INSURER.D: 455 W. 115th Ave. , Unit #5 INSURER E: Denver CO 80234 INSURER F: COVERAGES CERTIFICATE NUMBER:Certificate 2016-2017 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 ADDL SUER LTR TYPE OF INSURANCE POLICY EFF I POLICY EXP INSD WVD POLICY NUMBER (MMrllDIYYYY)I(MM1DDNYYY) LIMITS X COMMERCIAL GENERAL LIABILITY . EACH OCCURRENCE $ 1,000,000 A CLAIMS-MADE I X 1 OCCUR DAMAGE TO RENTED PREMISES(Ea occurrence) 5 300,000 BKS 55847265 11/21/2016 11/21/2017 MED EXP(Anyone person) $ 15 r000 PERSONAL&ADV INJURY $ 1,000,000 GE 'L.AGGREGATE LIMIT APPLIES PER: POLICY(X P� I LOC GENERAL AGGREGATE $ 2,000,000 PRODUCTS-COMP/OR AGO 5 2,000,000 OTHER: AUTOMOBILE LIABILITY $ COMBINED SINGLE LIMIT A X ANY AUTO (Ea accident) 5 1,000,000 ALL OWNED BODILY INJURY(Per person) $ AUTOS AUTOS BAS 55847265 11/21/2016 11/21/2017 BODILY INJURY(Peraccrdent) $ X HIRED AUTOS X NON-OWNED AUTOS PROPERTY DAMAGE $ (Per accident) X UMBRELLA L1AB - $ X OCCUR EXCESS LIAR EACH OCCURRENCE $ 1,000,000 A CLAIMS-MADE USO 55847265 11/21/2016 11/21/2017 AGGREGATE 5 1,000,000 DEC I X RETENTIONS 10,000 WORKERS COMPENSATION $ AND EMPLOYERST LIABILITY I PER ANY PROPRIETOR/PARTNER/EXECUTIVE Y1N - STATUTE I I EERH OFFICER/MEMBER EXCLUDED? I N/A E.L.EACH ACCIDENT $ (Mandatory in NH) _ if yes,describe under EL DISEASE-EA EMPLOYEE $ DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERAT(ONS I LOCATIONS I VEHICLES ACORD 101,Additional Remarks Schedule,may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Town of Vail THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Community Development Department ACCORDANCE WITH THE POLICY PROVISIONS. 75 S. Frontage Road West Vail, CO 81657 AUTHORIZED REPRESENTATIVE Fred Lail enbach/SENn -7,---;;-_-.-: y� ACORD 25 2014109 ©1988-2014 ACORD CORPORATION. All rights reserved. ( ) The ACORD name and logo are registered marks of ACORD INSO25(20141111 ® 3DATE{MMID D1YYYY) ACORD CERTIFICATE OF LIABILITY INSURANCE 11912017 CERTIFICATEU � MATTER Y CERTIFICATE AND CONFERS NO RIGHTS UPON THE CERTIFICATE DOES NOT ARMATIE AFFIRMATIVELY NEGATIVELY AMEND, 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: the certificate ADDITIONAL � lAADDITIONAL INSURED provisions ted. IfSUBROGAIONIS WAIVEDsubject to themsadconditons of the policy,certain policies may require an endorsement. statement h _ this certificate does not confer rights to the certificate holder in lieu of sucCONTACorsement(s NAME: 444-8481 PRODUCER PHONE 303-444-4666 I (AAAC.Nol 303- Arthur J. Gallagher Risk Management Services, Inc. (Air,Nn E,rtp 3005 Center Green Drive Suite 120 E-MAIL Boulder CO 80301 AnDRFS,R,' I INSURER(S)AFFORDING COVERAGE NAIC S INSURER A:Pinnacol Assurance Company 41190 INSURED WINDAME-01 INSURERS: Windows America of Colorado Inc INSURER C: I Clyde&Kathleen Lundeen INSURER D 455 W 115th Ave Unit 5 INSURER E: Denver CO 80234 INSURER F: COVERAGES CERTIFICATE NUMBER: 1339207295 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 REQUIREMENT, CONDITION CONTRACT LCOR DOCUMENT THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE Y THPOIESDESCRIEDHEEN IS SUBJECT TO ALL TERMS. EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. PS. LIMITS INSR ADDL SUER POLICY NUMBER 1 JMOLIC YEFF {POLICY Y P LTR TYPE OF INSURANCE INSD WV➢ EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY I DAMAGE TO RENTED 11 PREMISES(Ea occurrence} $ CLAIMS-MADE I I OCCUR MED EXP(Any one person) $ PERSONAL&ADV INJURY $ � GEN'L AGGREGATE LIMIT APPLIES PER'- GENERAL AGGREGATE $ PPRODUCTS-COMP/OP AGG $ CO ` l LOG POLICY - $ }OTHER- COMBINEt]SINGLE LIMIT 1$ {Ea accident) AUTOMOBILE LIABILITY BODILY INJURY(Per person) $ ANY AUTO BODILY INJURY(Per accident)I $ OWNED SCHEDULED AUTOS ONLY AUTOS PROPERTY DAMAGE $ HIRED — NON-OWNED (Per accident) AUTOS ONLY - I AUTOS ONLY $ UMBRELLA LIAEACH OCCURRENCE $ B OCCUR _ — AGGREGATE $ EXCESS LIAB CLAIMS-MADE $ DED I I RETENTION$ 3/1/2018 X I STATUTE I ORH A WORKERS COMPENSATION 4130206 AND EMPLOYERS'LIABILITY YIN E L.EACH ACCIDENT $1,000,000 ANY PROPRin NH) ARTNERIEXECUTIVE [ lOFFICEN!A (MandaRIMEM BER EXCLUDED? I E-L.DISEASE-EA EMPLOYEE$1,000,Ot10 (Mandatory in NH) I E.L.DISEASE-POLICY LIMIT $1,000,000 If yes. under DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS/LOCATIONS f VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Community Development Department oven Vail ACCORDANCE WITH THE POLICY PROVISIONS. 75 S.Frontage Road West Vail CO 81657 AUTHORIZED REPRESENTATIVE I ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD