HomeMy WebLinkAboutZAK DIRT INC - INSURANCE CERTIFICATE 2023-2024Ps2laK�2EYIP2
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A� � CERTIFICATE OF LIAB�LITY INSURANCE oaiaoiaaa3
THIS CERTIFICATE IS ISSUED AS A MA7TER OF INFORMATIpN �NI.Y AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDHR. THIS
GERTIFICATE �OES NQT AFFIRMATIVEtY OR kEGATiYELY AMEN�, FJ(TEND OR ALTER THE COVERAGE AFFDRDED BY TkE POLICI�S
BELOW. THIS CERTIFICATE OF INSURANCE �qES NOT CONSTITUTE A CONTRACT BETWEEN THfl ISSUING INSURER(S), AUTHdRIZE�
REPRESENTAi1VE OR PROOUCER, ANO THE CERTIFICATE HOL�ER.
IMPORTANT: If the certiflcate holder is an ADDITIONAL IkSURE�, the policy{issj must have A��ITIONAL INSURED provisions or be endorsed.
if 5UBROGATION IS WAIVED, subJeci ta the tarma and conditions of tha policy, cerlaln poNclaa may requlre an endoraement. A afatament on
this certiflcate does not confer rights to the cerlificate holder In Ilsu of such endorsemant{s .
PRODIICER 1-9a4-684-775D CONiACT Yelia Mencha
NAME:
HOlm@s ElllYyhy � A6BDC�.AGQO ^ CO PHONE FAIf
(Af�.114.FrN: ,vC �.
7600 8aat Orchnrd Aoad, 8uite 230 South noDR 88: �ncttnGholraeemuryhy.caAm
�reanr000d Villags, CO B0111
IM8lIRED
Znk Dirt, Ine.
16290 Hilltop AoaB
�ngmont, co easoa
INSUFiEFi S AFFORdN6 COYEFUOE
INSURERA: ZS11iICF1 Al68A IN8 CQ
iNStlRERB: T�+��g PROP CA8 IN8 CO
INBURERC: INDIAN HARBDR INS CO
IHSURERD: Xi, 996CIAIfiY IN8 CO
iHsuRea E :
NAIC
16535
36940
3T8B5 .....
COVERAGES CERTIFICATE NUMSER: 68ae1o93 REYISIpN NUMBfR:
THIS IS TO CER7IFY 7HAT 7HE POLICIES pF INSURANGE LIS7ED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERi00
IN�ICATED. NOTWITHSTANDING AMY REQUIREMENT, TERM QR CONDITION OF ANY GON7RACT OR 07HER DOCUMEIV7 WITN RESPECT i0 WHICH THIS
CERTIFICATE MAY BE ISSUE� OR MAY PERTAIN, THE INSURANCE AFFOR�Eb BY THE POLICIES DESCRIBED HEREIN 15 SUBJECi TO ALL THE TERMS,
EXCLUSIONS AND CONOITIONS OF SUCH POLICIES. LIMITS SHOWM MAY HAVE BEEN RE�UCEO BY PAIO CiAIl41S.
ILSR 7'YPEOFlti9URANCE A�GL°SU�R ppL�CYEFF pOUCTE%P LIMI'FS
POLICV NUi�BER MMNDIYI'YY MMlDQ
A % GOMMEitCIA1.DEMERIILLIABICITY 13L0485843307 OS/Ol/23 OS/O1/24 Fp,CHOCCURRENCE f a,000,000
ClAIMS-MADE x OCCUR PREM SE_S�Ee�ocarranre S 5D, 000
x ai nea: $2.500
MED E%P (My ane perwn� S 5. 000
PERSpN1LL8ADVINJUitY S 2,0OO,ODQ
GEN'LAGGREGATELIMITAPPLIESPER: GENERALAGGREGATE S 4�000.000
PdLIGY X jECT ��OC PRODUCTS-COMPIOPAGG S 4,000,000
OTHER: s
A AUTONto91tELIABtuTY H1►P485843307 05/Ol/23 05/OS/2d COM6INEOSikGIEUMfT s Z,OOO,OOQ
fEa acCdei�tl
X ANY AUTO 9pDILY INJURY (Per perspn) S
OWMEp SCHEQUIED BODILY INJURY (Per acddartq i
AUTOS ONLY AlJTQS
X HIfiED X NOM-0WNEO pROPER71%�pAMAGE S
AUi056NLY AUTOSONLY Pera m
S
B x Un�BRELu�LUB X OCCUR C�3T63466623r1N 05/Q1/23 OS/O1/24 �CHOCCURRENCE s 5,000,000
EXCESSLIAB CLA1M5•MADE AGGREGATE S Z,OOD,000
DED x RETENTIONS 10,00D s
A WORIcfR8COMPENSATIpN 9PC6858d310B O5/O1/23 O5/O1/26 g STATUTE ERH
AHp EMPLOYER,1' ilAB1L17Y Y 1 N -'—�
ANWROPRIETORIPARTNEWE)fECUTNE � N�A E.L.EACFfACCIOEI+fT S 1.000.000
OFFICE RIM EM BER EXCLUDED7
(ARRndi�Oryt In NHj E.L. Df5EA5E - EA EMPLOYEE S 1� 000� 000
Ijyes 406C�bRY�lf
pE3CRIPT10N pF OAERATION$ bebw E.L. DESfASE - POLlCY LIMIT S 1� OOO� 000
C Po1luEionlProlessionnl Liab. PSC00498T506 DS/O1/Z3 05f01l24 $1,ODU.000 Gimit 25,ODODed
D LQased/Ranted Squipment UM001144141dAa311 DS/01/73 05/O1/34 $1.000.004 Limit 1,OOODed
D Inatallation Floater UMUOf1a41CMri2311 OS/U1/Z3 05/O1/24 S�SO,U00 Limit 2,500ued
OE3CRIPTION Of OPERATIONB! LOCATIOHS! YEHICLES (ACOR� 107, Addilbnal R�muks 6oh�tlul�, m�y b� �ttecMd if mon apac� is nqulnd�
City of Port colline is included as aa additiorcal inaured as reepects tLe (ieueral Liability and Auto L3ability, es
raguired by vrritten contrace, Der tha policy tarroe and coa9it3one.
City of Fort Colline
F.O. Hox 580
Fart Colline. CO B6522-pdd0
ACORD 25 (2016103�
Ve�anche
68481093
SHOULD ANY OF THE ABOYE DESCRIBEC POLICIES BE CANCELLEG BEFORE
THH FJCPIRATION �ATE THEREOF, NOTICH WILL BE �ELNERE� IN
ACCOROANCE WRH THE POLICY PROYISIONS.
AUTHORIZERREARE$ENTATryE
49A �'!~ r "' -
� 1988-2095 ACORD CORPORATtON. All righta reserved.
The ACOR� name and logo are registered marks of ACORD
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