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Home My WebLink About210435 BROOKMANSCertificate - City of Wheat Ridge[20964]/DATE INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS AC -7"R" CERTIFICATE OF LIABILITY INSURANCE (MM/DD/YYYY) INSR LTR 05/10/2022 THIS CERTIFICATE IS ISSUED ASA 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 Fred Lautenbach NAME: Lautenbach Insurance Agency, LLC PHONE Ext): (303) 798-2534 AIC, No): (303) 798-2536 5721 S. Nevada St. EMAIL fred@lautenbachinsurance.com ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # Littleton, CO 80120 INSURERA: Owners Insurance Company 32700 INSURED INSURER B : Plnnacol Assurance Brookman's Heating & A/C, LLC INSURER C : Douglas and Amber Brookman INSURER D: 6159 S. Fenton Ct. INSURER E Littleton CO 80123 INSURER F COVERAGES CERTIFICATE NUMBER: Certificate 2021-2022 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 LTR TYPE OF INSURANCE ADDLISUBR INSD WVD POLICY NUMBER POLICY EFF (MM/DD/YYYY) POLICY EXP (MM/DD/YYYY) LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE � OCCUR FIEN 117U PREMISES Ea occurrence $ 300,000 MED EXP (Any one person) $ 10,000 PERSONAL &ADV INJURY $ 1,000,000 A 74507378 08/27/2021 08/27/2022 GEN'LAGGREGATE LIMITAPPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY PRO JECT LOC PRODUCTS -COMP/OP AGG $ 2,000,000 $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 Ea accident BODILY INJURY (Per person) $ X ANYAUTO A OWNED SCHEDULED AUTOS ONLY AUTOS 53-507378-00 08/27/2021 08/27/2022 BODILY INJURY (Per accident) $ PROPERTY DAMAGE $ Per accident X HIRED�/ NON -OWNED AUTOS ONLY /� AUTOS ONLY X UMBRELLA LIABX OCCUR EACH OCCURRENCE $ 1,000,000 AGGREGATE $ 1,000,000 A EXCESS LIAB CLAIMS -MADE 53-507378-01 08/27/2021 08/27/2022 DED X RETENTION $ 10,000 $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBEREXCLUDED? ❑ (Mandatory in NH) N/A 4232633 08/27/2021 09/01/2022 �/ /� STATUTE OTHER E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Re: Contractors License CERTIFICATE HOLDER CANCELLATION @ 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Wheat Ridge ACCORDANCE WITH THE POLICY PROVISIONS. 7500 W. 29h Avenue AUTHORIZED REPRESENTATIVE Wheat Ridge CO 80033 @ 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD City and County of Denver . Community Planning and Development www. denvergov.org/contractor licensing Issued To: BROCKMAN'S HEATING & A/C, LLC 6159 S. FENTON CT. LITTLETON, CO 80123 License/Registration Number: LIC00250637 Expiration Date: 10/31/2024 License Type: H & V B By Authority of the Executive Director of Community Planning and Development Amount Fund/Org/Revenue Code Payment Date Trans # Status $250.00 R353900-'-01010-0141200 10/19/2021 8439772 Paid RENEWAL INFORMATION Renewal notices will be e-mailed to e-mail address on P@newal information is available at www.denvergov.org/Contractor_Licensing. INSPECTION INFORMATION Inspection requests called in by 12:00 a.m. will usually be scheduled for the following working day. Please provide the following information when you call for an inspection: til Permit number Type of inspection and inspection code Automated Inspection Request System: 720-865-2501 Inspections are performed Monday through Friday. Wallet Contractor ID Card: MUST BE KEPT IN YOUR POSSESSION AT ALL TIMES. Cut on outside of line, then fold in half. City and County of Denver City and County of Denver Community Planning and Development IDENTIFICATION CARb 201 W COLFAX AVE DEPT 205 DENVER, COLORADO 80202 License/Registration LIC00250637 No.: DENVER This is to certify that BROOKMAN'S HEATING & A/C, LLC has been THE MILE HIGH CITY issued a H & V B license in ;the City and County of Denver, beginning on 19 October 2021 and ending on 31 Oct 2024, unless Licenses & Certificates: 720.865.2770 license is revoked. Permit Counter: 720.865.2720 Inspection Administration: '720.865.2505 By Authority of the Executive Director of Automated Inspection Request: 720.865.2501 Community Planning and Development LIC. 100 (4/100) CPDA LIC. 100 (4/100) CPDA