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HomeMy WebLinkAbout210495 PARAMOUNT ROOFING LTDCertificate - City of Wheat RidgePolicy Number: Date Entered: 7 . 8.2022 A� & CERTIFICATE OF LIABILITY INSURANCE D,18IM2 22TT, 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 PRODUCER H. Linwood Insurance 4021 Layang Layang #H CONTACT NAME: PHON (760)390-7094 FAX No): (442)500-2391 eIC.N,Ex: ADDRESS: garvey.hlinwoodins@yahoo.com Carlsbad, CA 92008 INSURERS) AFFORDING COVERAGE Ni 5.27 .2023 EACH OCCURRENCE $ 1,000,000 INSURERA: Kinsale Insurance INSURED paramount Roofing Ltd. INSURER B: INSURER C: Mr. Ryan Campbell D: 6565 South DaytonINSURER Suite #3700 INSURER E: Greenwood, CO 80111 LIABILITY MY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON-0WNED777777777777777- AUTOS ONLY AUTOS ONLY INSURER F: 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 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, EXCLUSIONSAND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. MEN LTB TYPE OF INSURANCE POOL RED SUBIR IWO POLICY NUMBER POLICY EFF MM/00/TTTT POLICY EXP MM/00/TTTT LIMITS A COMMERCIAL GENERAL LIABILITY CLAIMSMADE ®OCCUR THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Wheat 0100192347-0 5.27 .2022 5.27 .2023 EACH OCCURRENCE $ 1,000,000 77A777777777777`777- ' PREMISES (Ed occurrence $ 100,000 MED EASE(Any one person) $ 5000 PERSONAL & ADS INJURY $ 1,000,000 GEN IT AGGREGATE LIMIT APPLIES PER POLICY 0PTC7 E]LOC OTHER GENERAL AGGREGATE $ 2,000,000 PRODUCTS -COMPBOPAGG $ 2,000,000 $ AUTOMOBILE LIABILITY MY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON-0WNED777777777777777- AUTOS ONLY AUTOS ONLY COMBINED SINGLE Edaccident) $ BODILY INJURY(Perpemon) $ BODILY INJURY (Per accident) $ Peracodent $ UMBRELLA UAB EXCESS LIPS OCCUR CLAIMSMADE EACH OCCURRENCE $ AGGREGATE $ DED I I RETENTION $ $ WORKERS COMPENSATION- AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE� OFFICER/MEMBER EXCLUDED' (Mandatory in Ni fyes describe under DESCRIPTION OF OPERATIONS be N/A STATUTE ER EL EACH ACCIDENT $ EL. DISEASE -EA EMPLOYEE $ EIT DISEASE -POLICY LIMIT $ DE SCRIPTION OF OF ERATIONS/LOCATIONS /VEHICLES (A CORD 101, Additonal Remarks S cbedule, may be atla cbed if m ore space is required) Roofer Below Is Named As An Additional Insured CERTIFICATE HOLDER CANCELLATION City of Wheat Ridge 7500 W. 29th Avenue SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Wheat Ridge„ CO 80023 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE M Garvey Gunia ACORD 25 (2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD t,"Im OFFICIAL RESULTS REPORT Off\ INTERNATIONAL W14 - National Standard Roofing CODE COUNCIL Contractor/Subcontractor Name: ryan cam pbell Candidate ID: ICNON121785 Address: 11763 Elk Head Range Rd. Date: 2/26/2016 Littleton CO 80127 EXAMINATION RESULT: PASS Congratulationsl 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 authent/clty of this score report can be validated by using Pearson VUE's Online Score Report Authentication found at: www.PearsonVUE.com/,uthenticate Digital embossing eliminates the possibility of unauthorized embossing of counterfeit score reports. Registration Number. 295504380 Validation Number: 843487427 Scanned with CamScanner ♦SAI City of "� WheatRjdge COMMUNITY DEVELOPMENT 7500 W. 29th Avenue * Wheat Ridge, CO 80033 * O: (303)235-2855 * F: (303)235-2857 Contractor Waiver for Workers' Compensation Insurance I, (print your name), Ryan Campbell verify that I am the sole owner or partner of (company name): Paramount Roofina Ltd 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. R an Campbell Digitally signed by Ryan Campbell Signature: Y Date'. 2022.07.08 1024 33-00'00' Date: 07/08/22