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HomeMy WebLinkAbout210481 BUILDPRO LLCCOI City of Wheat Ridge (1)_Page_1ACORO° CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 06/08/2022 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 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 Julie Kuhlman NAME: Brown & Brown of Florida, Inc. PHONEo (386) 239-5742 FAx A/C NExt): A/C No): P.O. Box 2412 E-MAIL Julie.Kuhlman@bbrown.com ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # INSURERA: Redwood Fire and Casualty Insurance Company 11673 Daytona Beach FL 32115-2415 INSURED INSURER B: Berkshire Hathaway Homestate Insurance Company 20044 INSURER C: BUILDPRO, L.L.C. INSURER D: 22171 MCH Road INSURER E: INSURER F: MANDEVILLE LA 70471 COVERAGES CERTIFICATE NUMBER: 21-22 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 MAYBE 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 INSD WVD POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DD/YYYY LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ DAMAGE TO RENTED CLAIMS -MADE F-1 OCCUR PREMISES Ea occurrence) $ MED EXP (Any one person) $ PERSONAL&ADV INJURY $ GEN'LAGGREGATE LIMITAPPLIES PER: GENERAL AGGREGATE $ POLICY ElPRO-❑LOC JECT POTHER PRODUCTS-COMP/OPAGG $ $ AUTOMOBILE LIABILITY CEa aOMBINED INGLE LIMIT $ ccidentS BODILY INJURY (Per person) $ ANYAUTO OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Per accident) $ PR OPERTY DAMAGE $ Per accident HIRED NON -OWNED AUTOS ONLY AUTOS ONLY UMBRELLA LAB HCLAIMS-MADE OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LAB DED RETENTION $ $ WORKERS COMPENSATION X C AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? ❑ (Mandatory in NH) N/A (MS) MAWC234817 07/01/2021 07/01/2022 STATUTE EORH 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 E.L Each Accident $1,000,000 E Workers Compensation And Employers' Liability (FL) MAWC235129 07/01/2021 07/01/2022 E.L Disease -Ea Emp. $1,000,000 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) SEE NOTES FOR POLICY COVERAGE FORMS. WORKERS COMPENSATION APPLIES TO ALL STATES, EXCLUDING ND,OH,WA,WY 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 CITY HALL ACCORDANCE WITH THE POLICY PROVISIONS. 7500 W 29TH AVE 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 ACORO° CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 06/08/2022 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 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 Julie Kuhlman NAME: Brown & Brown of Florida, Inc. PHONEo (386) 239-5742 FAx A/C NExt): A/C No): P.O. Box 2412 E-MAIL Julie.Kuhlman@bbrown.com ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # INSURERA: Redwood Fire and Casualty Insurance Company 11673 Daytona Beach FL 32115-2415 INSURED INSURER B: Berkshire Hathaway Homestate Insurance Company 20044 INSURER C: BUILDPRO, L.L.C. INSURER D: 22171 MCH Road INSURER E: INSURER F: MANDEVILLE LA 70471 COVERAGES CERTIFICATE NUMBER: 21-22 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 MAYBE 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 INSD WVD POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DD/YYYY LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ DAMAGE TO RENTED CLAIMS -MADE F-1 OCCUR PREMISES Ea occurrence) $ MED EXP (Any one person) $ PERSONAL&ADV INJURY $ GEN'LAGGREGATE LIMITAPPLIES PER: GENERAL AGGREGATE $ POLICY ElPRO-❑LOC JECT POTHER PRODUCTS-COMP/OPAGG $ $ AUTOMOBILE LIABILITY CEa aOMBINED INGLE LIMIT $ ccidentS BODILY INJURY (Per person) $ ANYAUTO OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Per accident) $ PR OPERTY DAMAGE $ Per accident HIRED NON -OWNED AUTOS ONLY AUTOS ONLY UMBRELLA LAB HCLAIMS-MADE OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LAB DED RETENTION $ $ WORKERS COMPENSATION X C AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? ❑ (Mandatory in NH) N/A (MS) MAWC234817 07/01/2021 07/01/2022 STATUTE EORH 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 E.L Each Accident $1,000,000 E Workers Compensation And Employers' Liability (FL) MAWC235129 07/01/2021 07/01/2022 E.L Disease -Ea Emp. $1,000,000 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) SEE NOTES FOR POLICY COVERAGE FORMS. WORKERS COMPENSATION APPLIES TO ALL STATES, EXCLUDING ND,OH,WA,WY 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 CITY HALL ACCORDANCE WITH THE POLICY PROVISIONS. 7500 W 29TH AVE 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 AGENCY CUSTOMER 10: F^� LOCp: A`dROP ADDITIONAL REMARKS SCHEDULE Page of AGENCY GO MEDINSURED FDA, A B,,,, of F ANN, 1,, MARC JONES CONSTRU �1 ON LL C DENY SUNPRO SOLAR GO LICY NUMBER CARR I ED NA IC CODE I EFFECTME DATE ADDITIONAL REMARKS THIS ADDRIOKAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORMKUMBER:25FORM TITLE C ebllit Insurance Notes CAMEDINSURED MARCJONES CONSTRUCTION LLC BUFFERED SOLAR �C MARCJONES CONSTRUCTION LLC DENY ENERGYPRO MARCJONES CONSTRUCTION LLC DENY SUNPRO SOLAR COMPASS SOLAR GROUP LLC CURRENT BLANKET POLICY FORMS WORKERS COMPENSATION 1)wc000313 0484 werveR OF OUR RIGFFTO RECOVER FROM OTHERS ENDORSEMENT SPARER OF SUBROGATION) ACORD 101 (200801) © 2008 ACORD CORPORATION. All ngb6 reserved. TheACORD name and logo are registered matl5 o1ACORD AGENCY CUSTOMER 10: F^� LOCp: A`dROP ADDITIONAL REMARKS SCHEDULE Page of AGENCY GO MEDINSURED FDA, A B,,,, of F ANN, 1,, MARC JONES CONSTRU �1 ON LL C DENY SUNPRO SOLAR GO LICY NUMBER CARR I ED NA IC CODE I EFFECTME DATE ADDITIONAL REMARKS THIS ADDRIOKAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORMKUMBER:25FORM TITLE C ebllit Insurance Notes CAMEDINSURED MARCJONES CONSTRUCTION LLC BUFFERED SOLAR �C MARCJONES CONSTRUCTION LLC DENY ENERGYPRO MARCJONES CONSTRUCTION LLC DENY SUNPRO SOLAR COMPASS SOLAR GROUP LLC CURRENT BLANKET POLICY FORMS WORKERS COMPENSATION 1)wc000313 0484 werveR OF OUR RIGFFTO RECOVER FROM OTHERS ENDORSEMENT SPARER OF SUBROGATION) ACORD 101 (200801) © 2008 ACORD CORPORATION. All ngb6 reserved. TheACORD name and logo are registered matl5 o1ACORD vrri%,IAL KtSULTS REPORT ,KRI���_ � lI INTERNATIONAL F11 -National Standard General Building CODE COUNCIL Contractor (A) Name: Matt Graham Candidate ID: ICNON149682 Address: 425 Dockside Drive Date: 1/5/2021 Slidell LA 70461 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 888422-7233 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. me auM¢ntlOfy oI tots score report ren Oe velleateO ny uLno asrem -E's "n'Store Report Authenn'vtlun rpype at Olflltal em0assln9 ellminatez ene wwblbry oI unnu/nonmE-em0ozvn0 a cpunferfelt sNre mpprtz. Repisbatbn N.", 38)6]8313 V.hd.W Number &0038)13) COVERAGES CERTIFICATE NUMBER: ATL -005436378-02 REVISION NUMBER: 4 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 ,a`oRo° CERTIFICATE OF LIABILITY INSURANCE ATE D06/10/2022D/YYYY) INSR LTR TYPE OF INSURANCE 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 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 Beatrice Cannavale NAME: Marsh USA Inc. 1-212-345-7215 AIC 1560 Sawgrass Corporate Pkwy, Suite 300 A/CNNo Ext : NO)7 E-MAIL Beatrice.Cannavale@marsh.com ADDRESS: Sunrise, FL 33323 Attn: ADT.certs@marsh.com CLAIMS -MADE 1XI OCCUR INSURER(S) AFFORDING COVERAGE NAIC # wsURERA:Old Republic InsuranceCc 24147 CN 109418288-MJC-GA-2022 INSURED BUILDPRO, L.L.C. INSURER B : X MED EXP (Any one person) $ 10,000 22171 MCH ROAD INSURER C : INSURER D: MANDEVILLE,LA 70471 INSURER E : Professional Liab Included PERSONAL & ADV INJURY INSURER F: X COVERAGES CERTIFICATE NUMBER: ATL -005436378-02 REVISION NUMBER: 4 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 ADDL INSD SUBR WVD POLICY NUMBER POLICY EFF MMIDD/YYYY POLICY EXP MMIDD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY MWZY 31431821 10/01/2021 10/01/2022 EACH OCCURRENCE $ 4,500,000 CLAIMS -MADE 1XI OCCUR PREM SES Ea occurrDence $ 1,000,000 X MED EXP (Any one person) $ 10,000 SIR: $500,000 Professional Liab Included PERSONAL & ADV INJURY $ 4,500,000 X AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 9,000,000 GEN'L X POLICY ❑PRO JECT ❑ LOC PRODUCTS - COMP/OP AGG $ 9,000,000 $ OTHER: A AUTOMOBILE LIABILITY MWTB31431921 10/01/2021 10/01/2022 COMBINED SINGLE LIMIT Ea accident $ 5,000,000 BODILY INJURY (Per person) $ X ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ HIRED NON -OWNED AUTOS ONLY AUTOS ONLY UMBRELLA LAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LAB CLAIMS -MADE DED RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN PER OTH- STATUTE ER ANYPROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? ❑N NIA E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS /VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more space is required) CERTIFICATE HOLDER CANCELLATION City of Wheat Ridge City Hall SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 7500 W 29th Ave THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Wheat Ridge, CO 80033 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ren - / �7 ACORD 25 (2016/03) ©1988-2016 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: CN109418288 LOC #: Lauderdale ,a`oRo ADDITIONAL REMARKS SCHEDULE Page 2 of 2 AGENCY NAMED INSURED Marsh USA Inc. BUILDPRO, L.L.C. 22171 MCH ROAD POLICY NUMBER MANDEVILLE, LA 70471 CARRIER I NAIC CODE EFFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: Certificate of Liability Insurance THE FOLLOWING ARE INCLUDED AS ADDITIONAL NAMED INSUREDS ON THE LISTED POLICIES AS OF 01/30/2022: MARC JONES CONSTRUCTION, LLC BUILDPRO, LLC MARC JONES CONSTRUCTION, LLC DBA BUILDPRO MARC JONES CONSTRUCTION, LLC DBA ENERGYPRO COMPASS SOLAR GROUP, LLC MARC JONES CONSTRUCTION, LLC DBA SUNPRO SOLAR **(NOTE: MARC JONES CONSTRUCTION, LLC DBA SUNPRO SOLAR PROCURED A NAME CHANGE TO BECOME ADT SOLAR LLC ON 04/18/2022) THE FOLLOWING IS INCLUDED AS ADDITIONAL NAMED INSURED ON THE LISTED POLICIES AS OF 04/18/2022: ADT SOLAR LLC CURRENT BLANKET POLICY FORMS GENERAL LIABILITY: CG 20 10 12 19 -ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION CG 20 37 12 19 -ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - COMPLETED OPERATIONS CG 24 04 12 19 - WAIVER OF TRANSFER OF RIGHTS OF RECOVERYAGAINST OTHERS TO US (WAIVER OF SUBROGATION) PGL 237 08 17 -ADDITIONAL INSURED - SCHEDULED PERSON OR ORGANIZATION - PRIMARYAND NON-CONTRIBUTORY BASIS AUTO LIABILITY: CA 20 48 10 13 - DESIGNATED INSURED FOR COVERED AUTOS LIABILITY COVERAGE CA 20 01 10 13 - LESSOR - ADDITIONAL INSURED AND LOSS PAYEE CA 04 44 10 13 - WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US (WAIVER OF SUBROGATION) ACORD 101 (2008/01) © 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD