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HomeMy WebLinkAbout210488 BROWN PLUMBING AND HEATINGBrown Plumbing Certificate of Liability Insurance City of Wheat Ridgem ACORDCERTIFICATE AF I_IARII ITV IMM IRAM1_F nM 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 INSURERIS), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER, IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the pollcy(les) must haaa ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, wbfecl to the terms and conditions of the paltry, certain policies may require an endorsement. A statement an this certiTiTzte does not wMer ri Ms t3 fha certificate holder in lieu OI wch endorsements FEDERATED MUTUAL INSURANCE COMPANY HOME OFFICE: P.O. BOX 326 oHTUT -a!E (AX AK Mp:SWi46-[BBC 4DDgElS: CLIENT TC NT R F INS.[ M OWATONNA, MN S60B0 61 AFFORDING COVERAGE NAIL R X COMMERCIALOENERALUAAIUTY CW 1-1 OCCUR gINSU!EA INKIRER A, FEDERATED MUTUAL INSURANCE COMPANY 13835 N MlDRED 265-9360 INJURER a: T BROWN INC 1400 VIOLET AVE Inapneac: D: BOULDER, CO 50304-MINJURER IxaURER E: L /AOR�IE]IFUMIT PPPUFB P[R'. X Po°CY LJ'MCT ST. psVRER F: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PE OX) 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. Inas°p TYPE OF INSURANCE 6V pOLkY NUMBER NPMILICY Err III LIMIT9 A X COMMERCIALOENERALUAAIUTY CW 1-1 OCCUR N N 9920861 "12022 0401o2023 $ALN OCOURRENC 51,000,000 DAMAOET RENTED $100,000 MED EXP IMV NXP—I EXCLUDED Pen-A.a ADVI-nT $1,OOQ000 L /AOR�IE]IFUMIT PPPUFB P[R'. X Po°CY LJ'MCT ST. OCNENAa AOOREOATE $2,000,000 PRODUCTS A DOW," ACO $2,000,000 A AUTOMOBILE LIABILITY X MN MTO OWNED _on ca,f�CUL[D WIRED WTOS ONIY 0.11-03 AUTO- ONLY N N 9920861 04101/2022 D47D1/2023 COMEINEO ENOU MIT $1000,000 XY IM1r l mm DONLY INJURY IM MdFXIa PROPERTY DANAOE A X UMBR UAS, !XC[lX LIAR dop RETENTION X OCCUR "A"' PIM N N 9920063 04/01/2022 0401/2023 F/KX OCCVMCXCC $1,000,OW ASOR[OATE $1=000 NOREERSCOMPSX AION AND EMPLOVFRB'LIANLITY ANY PROMIETORIPARTNERIEXECUTIVE OFRCFRIMEMSIR EXCLUDED! I-. In XNI I nr, FMXIM uMFr MISRIPTION OF WFRATIDNa LRNX NIA OWN PFR !}ATUT! pp E.L. Each ACCIDENT IF L 04[PR[ • RA EMPLOY[[ !.L CINM[ -POLICY UNIT DESCRIPTION OF ONDUTMNa 1 LOCATIONa I VFMCLEE pussan 101, asNnI R-1G-,mq MFlaIIJ 11 nen usa it raI CFRTKM2TF NDI fYD 266.9340 1560 CITY OF WHEAT RIDGE BUILDING SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 7500 W 29TH AVE THEEXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN WHEAT RIDGE, CD W033-8001 ACCORDANCE WITH THE POUCY PROVISIONS. THCRRED REPRE[ENTATIIW 0 1981 ACORD CORPORATION. Al rights reserved. AWHIJ as (N10nM) IME AULIKU name and logo are registered marks of ACORD 'ORO® CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 07/12/2022 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(sl. PRODUCER Pinnacol Assurance 7501 E. Lowry Blvd. Denver, CO 80230-7006 AFFORDING COVERAGE Pinnacol Assurance INSURED T Brown Inc dba Brown Plumbing & Heating 1400 Violet Ave Boulder, CO 80304 COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: 41190 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. INR TYPE OF INSURANCE AD SUBR POLICY NUMBER MM/DD EFF MM/DD/YY POLICY P LIMITS Douglas County Insurance Services, COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMS -MADE FlOCCUR R PREMISES Ea occurrence $ MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY ❑ JECOT- F LOC PRODUCTS - COMPIOP AGG $ $ OTHER: AUTOMOBILE LIABILITY COM IN£D SINGLE uliflrf a accident $ BODILY INJURY (Per person) $ ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ HIRED NON -OWNED AUTOS ONLY AUTOS ONLY a UMBRELLA LIABOCCUR EACH OCCURRENCE $ AGGREGATE $ EXCLIAB ESS CLAIMS -MADE DED RETENTION $ $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANYPROPRIETOR/PARTNER/EXECUTIVE YIN OFFICER/MEM BER EXCLUDED? F-1 .(Mandatory in NH) NIA 4164026 04/01/2022 04/01/2023 X PER STATUTE OTH- ER 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) Unless otherwise stated in the policy provisions, coverage in Colorado only. CERTIFICATE HOLDER CANCELLATION 2269004 City of Wheat Ridge 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 Douglas County Insurance Services, © 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD ACORDs orovided by Forms Boss. www.FormsBoss.com: (c) Imoressive Publishina 800-208-1977 Division of Professions and Occupations State Plumbing Board Anthony L Brown Master Plumber MP.00178816 03/01/2021 Number Issue Date Active 02/28/2023 Credential Status 'Expire Date Ve ty this credential at: doo.culoracio, goy 1-1400 L Division State Plumbing Board T Brown Inc Brown Plumhinr ene Neeting Plumbing Contractor PC.0000635 03/01/2021 Number 1&e Date Active 0248/2023 Credential Statas 4Epire Date V/fy this credeptial at: dpo cutorado. goy Colorado Department of Regulatory Agencies Division of Professions and Occupations State Plumbing Board Anthony L Brown Master Plumber MP.D0178816 03/01/2021 Number l iue Date Active - OZ/2B/2023 Credential Status !�Expfre Date Ve ify this credential at dpo.cclorado.goy 7du,ll — I Division of Professions aid'©ccupations State Plumbing Board �r) T Brown,nty�., Brown pi and -tlnr Plumoingcontrac[br l• PC,0000635 03/01i2021f' Number Issue Date Active 02/28/2023 Credential Status Expire Date Velfly this credential at: dpo.celorndogo- N