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2020/03/01 TMS Construction, Inc.
TMSCONS-01 AL "PC" DATE (MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 2/26/2020 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 endorsements . PRODUCER PFS Insurance Group 4848 Thompson Parkway Suite 200 Johnstown, CO 80534 INSURED TMS Construction, Inc PO Box 76197 Colorado Springs, CO 80970 rJ Z►1 mq-T.rr73d l:COTI Cif -A TF Id IRRIPFR- rnvn� Ext): (970) 635-9400 iw_c, III A"' �s;lnfoi@mypfsinsurance.com INSUAMS) AFFORDING COVERAGE INSURER A : Valley Forge Insurance INSURER ,s:Continental Casualty INSURER C : Plnnacol Assurance Co INSURER D INSURER E : INSURER F t7RVIQInW kit IMRRR• 635-9401 NAIC # 20443 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 TYPE OF INSURANCE ,ADDL SVBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE [X] OCCUR X 6057425554 3/1/2020 3/1/2021 DAMAGE TO RENTED 100,000 X IVIED EXP (Ang oneperson) $ 15,000 Blkt Add'1 Insured X Blkt Waiver of Subro PERSONAL &ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE 2,000,000 PRODUCTS - COMP/OP AGG $ 2,000,000 POLICY I X J PE0 [ I LOC OTHER' AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ BODILY INJURY Perperson) $ ANY AUTO BODILY INJURY Per accident $ OWNED SCHEDULED AUTOS ONLY AUTOS PPROPPE, TY AMAGE eB $ HIRED NON SV ED AUTOS ONLY AUTOS ONLY B X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 5,000,000 LIAB CLAIMS -MADE 6057425568 3/1/2020 3/1/2021 TEXCESS AGGREGATE $ 5,000,000 D I X I RETENTION $ 10,000 C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y f N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? 1 ] (Mandatory in NH) N / A .4055188 3/1/2020 3/1/2021 X PER OTH- EL EACH AQr JDENT 1,000,000 $ E.L DISEASE - EA EMPLOYEE $ 1,000,000 L. DISEASE -POLICY LIMIT 1000,000 ' If yes, descrihe under DESCRIPTION OF OPERATIONS below, A Leased/Rented Equip 115057425554 3/1/2020 3/1/2021 :$5,000 Deductible 250,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more apace Is required) If required by written contract, the Certificate Holder is included as Additional Insured for ongoing operations under General Liability. rE HOLDER Ulty OT MOT1110%; CANCELLATION City Clerk SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Menifee THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 29714 H n Road ` LU ACCORDANCE WITH THE POLICY PROVISIONS. Sun City, CA 92586 K AUTHORIZED REPRESENTATIVE Received "Ag& — ACORD 25 (2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD