Loading...
HomeMy WebLinkAbout210506 MIDWEST PLUMBINGCERT City of Wheat RidgeMIDWPLU-01 IRROWN ,acoRO CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYY) 81412022 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 SU BROGATION 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 Christie Mueller NAME: PHONE FAX (A/C, No, Ext): (720 ) 583-1599 (A/C, No): Inszone Insurance Services, LLC 2721 Citrus Road, Suite A Rancho Cordova, CA 95742 E-MAIL R'ESS, cmueller@inszoneins.com INSURERS AFFORDING COVERAGE NAIC # INSURERA:Secura Insurance Company 22543 INSURED INSURER B: Plnnacol Assurance 41190 INSURER C: MidWest Plumbing Co LLC INSURER D: 1/15/2022 12587 W Dakota Ave Lakewood, CO 80228 INSURER E DAMAGE TO RENTED PREMISES Ea occurrence INSURER F: MED EXP (Any oneperson) 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, 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 MMIDDIYYYY POLICY EXP MMIDDIYYYY LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE [X]OCCURTC3358596 1/15/2022 1/15/2023 DAMAGE TO RENTED PREMISES Ea occurrence 100 000 $ MED EXP (Any oneperson) $ 10,000 PERSONAL & ADV INJURY $ Included AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 GENT X POLICY jEa LOC PRODUCTS - COMP/OPAGG $ 2,000,000 $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ BODILYINJURY Perperson) $ ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY Per accident $ PeOaccident DAMAGE $ HIRED NON -OWNED AUTOS ONLY AUTOS ONLY r UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DED FFRETENTION $ $ IS WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y 1 N ANY PROPRIETOR/PARTNER/EXECUTIVE Ll OFFICER/MEMBER EXCLUDED? (Mandatory in NH) NIA 4234849 1/16/2022 2/1/2023 PER OTH- STATUTE ER EACH ACCIDENT 100,000 $ E.L. DISEASE- EA EMPLOYEE 100,000 $ 100,000 If yes, describe under 500,000 DESCRIPTION OF OPERATIONS below E.L. DISEASE- POLICY LIMIT $ DESCRIPTION OF OPERATIONS 1 LOCATIONS 1 VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Verification of Insurance CERTIFICATE HOLDER CANCELLATION ACORD 25 (2016103) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Cit of Wheat Rid City Ridge THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 7500 W 29th Ave Wheat Ridge, CO 80033 AUTHORIZED REPRESENTATIVE ACORD 25 (2016103) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD 11 Ad of 0 er 10 1p of fe /le I re ime or Io or I f of If fI fo Of r of Alt If - r/// If Of,r If of 0 of Ae //jyyr./e'v�i. ;/iii%%/✓���y� •/i OF rzf, 0 do / oo/ of /,i //f Ire�f /)/ /j /� Wol ////Ile If J /!%' //� j;//,/iii/' j�!.../!''/�%'/.!/! / / /i: i/ If /'///// // / //40 -- . • t PYL•.-.- , 0 Off +may y Colorado Department of Regulatory Agencies Division of Professions and Occupations State Plumbing Board James Edsel Stanley Master Plumber MP.03000581 03/01/2021 Number Issue Date Active 02/28/2023 Credential Status Expire Date Verify this credential at: dpo.col ado.gov &nthf / I Division Director. Ronne Hines Cr dentia) Holder Signature