HomeMy WebLinkAbout210460 LITTLE RIVER CONSTRUCTIONIMG_0005.heic (1)Name:
John Duncan
Address: 3537 W 113th Ave
Westminster CO 80031
Candidate ID: ICNON138478
Date: 6/7/2021
EXAMINATION RESULT: PASS
Congratulations! You have passed the above-named examination. You will be able to verify your pass
status on the ICC website within 48-72 business hours after your exam. Please contact your
participating jurisdiction if you wish to pursue licensing.
A passing score on this examination satisfies the testing requirements for licensure only, and does not
guarantee that licensing will be granted. The candidate must also satisfy all local ordinance requirements
in each jurisdiction where licensing is desired.
It is extremely important that you notify Pearson VUE and ICC of any changes in name and/or address to
avoid the possibility of future correspondence not being received. Please contact both Pearson VUE at
877-234-6082 and ICC at 888-422-7233 ext. 5524 with changes to your name and address.
ICC reserves the right to amend or withhold any examination scores if, in its sole opinion, there is
adequate reason to question their validity.
The authenticity of this score report can be validated by using Pearson VUE's Online Score Report Authentication found at:
www.PearsonVU com/authenticate
Digital
embossing eliminates the possibility of unauthorized embossing of counterfeit score reports.
Registration Number 399118195
Validation Number: 282261559
OFFICIAL RESULTS REPORT
INTERNATIONAL
CODE COUNCIL
F13 - National Standard Residential
Building Contractor
(C)
Name:
John Duncan
Address: 3537 W 113th Ave
Westminster CO 80031
Candidate ID: ICNON138478
Date: 6/7/2021
EXAMINATION RESULT: PASS
Congratulations! You have passed the above-named examination. You will be able to verify your pass
status on the ICC website within 48-72 business hours after your exam. Please contact your
participating jurisdiction if you wish to pursue licensing.
A passing score on this examination satisfies the testing requirements for licensure only, and does not
guarantee that licensing will be granted. The candidate must also satisfy all local ordinance requirements
in each jurisdiction where licensing is desired.
It is extremely important that you notify Pearson VUE and ICC of any changes in name and/or address to
avoid the possibility of future correspondence not being received. Please contact both Pearson VUE at
877-234-6082 and ICC at 888-422-7233 ext. 5524 with changes to your name and address.
ICC reserves the right to amend or withhold any examination scores if, in its sole opinion, there is
adequate reason to question their validity.
The authenticity of this score report can be validated by using Pearson VUE's Online Score Report Authentication found at:
www.PearsonVU com/authenticate
Digital
embossing eliminates the possibility of unauthorized embossing of counterfeit score reports.
Registration Number 399118195
Validation Number: 282261559
ACORO° CERTIFICATE OF LIABILITY INSURANCE
MM/DD/YYYY)
761/6/2022
TYPE OF INSURANCE
INSD
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
NAME: Munro Insurance Services
Munro Insurance Services
(A/CNNO Ext): 760-621-3844 FAX
No):
1155 Sportfisher Dr. Suite 140
E-MAIL
ADDRESS: certs@munroinsuranceservices.com
INSURER(S) AFFORDING COVERAGE
NAIC #
INSURER A : Preferred Contractors Insurance Company, RRG.
12497
Oceanside CA 92054
INSURED
INSURER B
INSURER C:
PERSONAL & ADV INJURY
Little River Construction LLC
INSURER D:
AGGREGATE LIMIT APPLIES PER:
POLICY PRO JECT1:1 LOC
OTHER:
3537 W 113th Ave
INSURER E :
X
PRODUCTS - COMP/OP AGG
1 INSURER F:
Westminster CO 80031-7162
COVERAGES CERTIFICATE NUMBER: 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 CONTRACTOR 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.
LTR
TYPE OF INSURANCE
INSD
WVD
POLICY NUMBER
(MM DD YYYY)
(MM/DDYYYPY)
LIMITS
A
X
COMMERCIAL GENERAL LIABILITY
X CLAIMS -MADE E] OCCUR
Y
Y
PCA5026-PCCM418002
1/15/2022
1/15/2023
EACH OCCURRENCE
$ 1,000,000
PREMISES (Ea occurrence)
$ 50,000
MED EXP (Any one person)
$ 5,000
PERSONAL & ADV INJURY
$ 1,000,000
GEN'L
AGGREGATE LIMIT APPLIES PER:
POLICY PRO JECT1:1 LOC
OTHER:
GENERAL AGGREGATE
$ 2,000,000
X
PRODUCTS - COMP/OP AGG
$ 1,000,000
$
AUTOMOBILE LIABILITY
ANY AUTO
ALL OWNED SCHEDULED
AUTOS AUTOS
NON -OWNED$
HIRED AUTOS AUTOS
(Ea accident)
$
BODILY INJURY (Per person)
$
BODILY INJURY (Per accident)
$
(Per accident)
UMBRELLA LIAB
EXCESS LIAB
OCCUR
CLAIMS -MADE
EACH OCCURRENCE
$
AGGREGATE
$
DED RETENTION $
$
WORKERS COMPENSATION-
AND EMPLOYERS' LIABILITY Y / N
ANY PROP RIETOR/PARTNER/EXEC UTIVEF-1N
OFFICER/MEMBER EXCLUDED?
(Mandatory in NH)
If yes, describe under
DESCRIPTION OF OPERATIONS below
/A
STATUTE ER
E.L. EACH ACCIDENT
$
E.L. DISEASE- EA EMPLOYEE
$
E.L. DISEASE -POLICY LIMIT
$
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
Certificate Holder is listed as an Additional Insured.
CERTIFICATE HOLDER CANCELLATION
U 1988-2014 ACORD CORPORATION. All rights reserved.
ACORD 25 (2014/01) 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, Colorado
ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE
U 1988-2014 ACORD CORPORATION. All rights reserved.
ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD
City Of
t ld
COMMUNITY DEVELOPMENT ge
7500 W. 29th Avenue * Wheat Ridge, CO 80033 * 0: (303)235-2855 * F: (303)235-2857
Contractor Waiver for
Workers' Compensation Insurance
I, (print your name), 7a k., P
verify that I am theāsole owner or partner of (company name):
which has no employees and is not required by the State of Colorado to
carry workers' compensation insurance.
I further state that if I hire contractors/subcontractors, they are in
compliance with the State of Colorado Workers' Compensation insurance
requirements, have obtained the required contractor's license from the City
of Wheat Ridge and will be listed on the permit.
Signature:
Date: D 6-"- d- )-