HomeMy WebLinkAboutCOLORADO CIVIL INFRASTRUCTURE, INC. - INSURANCE CERTIFICATE� bA7E (MNiDDlYYYY)
A�ORO� CERTIFICATE OF LIABILITY INSURANCE ���grz02A
TNIS CERTIFIGATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICAtf HOLDER. Tiif5
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGAI�VELY AMEND, EXTEND pR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE bF INSURANCE DOES NOT CONSTtTUTE A CONTRACT BETWEEN THE ISSUING INSURER(S}, AUTWORIZED
REPRESEtJTAiIVE OR PRODUCER, AHO THE CERTIFICATE HQLDER.
IMPOATAtVT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL lN5URE0 provisions or be endorsed.
if Sl18ROGATiON IS WAIVED, subject to the terms and condfNons of the policy, Certain policies may require an endorsement. A statement on
this certiflcate doe5 not confer ri hts to the certlffcate holder In lieu of such endorsement(s .
PAODUCER
NaME � Samuel Feldmart
CRS Insurance Brokerage PHONE . 303-996-7800 � ac r,o : 303-757-7719
9780 S Meridian Blvd Suite 400 E�Ma�
Englewood CO 80t 12 no�aess: sfeldm_ an cLiicrsdenver com _
iNSURED
Colorado Civil Infrastructure, Inc.
2049 W Hamilton PI.
Englewood CO 80110
INSURERA: �If1f12C0�l�SSUf3f1CB
coav•z �Nsus�Re: Selective Ins. Co of Amerfca
INSURE R C :
INSUREfi D :
lNSURER E :
NAIC 0
41190
12572
COVERAGES CEA7IFICATE NUMBER:2009667939 REVISION NUMBER:
THIS IS TO CERTIFY THAT iHE POtICIE5 OF INSURANCE LISTED BELOW HAVE BEEN ISSl1ED TO THE INSURED NAMED ABOVE FOR THE POLICY PERI00
INOICATED. NOTWlTHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR 07tiER D�CUMENT WITH RESPECi t0 WHICH THIS
CERTIFICATE MAY BE ISSUED OFi MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLIGES DESCRI$EI� HEREIN IS SUBJFCT TO ALL THE TERMS.
EXCLUSIONS AND CpNDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR ADOL SUBR POLICY EFF POLICY EXP
LTR TYPEOFINSURAHCE IN O WV01 POUCYNUM9ER MAI�'DDlYYYY MMlDDIYYYY LiMTS
8 X COMMERCIALGENEqALL1A81UTY y S2505300 3/1l2023 31112Q24 EqCHOCCURRENCE 51.000,000
CLAIMS•MADE x pCCUR DAMA 10 R N
J _ PRCMISES (£a ocairrence}_ S 5d0,00Q
� MED ExP tAny oro pe�son) S 15,000
I PERSOVAL & hOV INJURY 5 1.00O,D00
G£N'L AGGREGATE LIMIT APPLIES PER. GENERAL AGGREGATE 52,000,000
pOUCY � �E � LOC PRp6UCTS - COMP;OP AGG b 2.004,006
QTHER S
B AUTOMOBILE UABIUTY 52505300 3/1l2923 3r�t2o24 COMBINED SINGLE L� S 1.000,000
�Ea a:ndenl)
x ANY AUTO BpDILY INJURV (Per person} y
OWNE� SCHEDULED j BODILY IN,IURV (Pe� ax�dentl $
� AUTOS ONLY AUTOS
x� HiREO X NONOWNED PROPERTYDAMAGE S
AUTOS O�ILY AUi05ONLY �tPer acciden�(
j J a
B X i uMBRELUILIAB � p�CUR 525053d0 � 3l1l2023 3/1/2024 � EqCHoc;CURflENCE 55,000.000
� Ef(CESS tIA6 ���,q�MS-MAOE ff AGOREGAT£ S 5,OOD,OOU
� DEO I^ j RETENTIONS { �f b
q WORKERSCOA7PENSATION 4189142 � 2J1l2024 211J2O25 X SFATUTf E�Rµ
AND EMPLOYERS' LIABILiTY
YtN
ANYPROPFIETOR�PAR7NEPoEXECUTIVE � N/ A E.L EACH ACGIDENi E 1.000,000
OFFICER'MEA46E R EXCLUOED?
{Mandatory In NM) ! � E L DISF.ASE EA FMPL.OYEE S 1,000,000
� tl yo-s, describe wider
I pESCRIPTION OF OPEflATIONS bebw E I E.L DISEASE - POLICY LIMIT j 1,000,000
B Leased end Rented Equipment 525053Q0 3/1/2023 3/1/2024 LimA 100,004
Dedu cubl e 1, 000
DESCRIPTION OF OVERATIONS+ LOCATIONS YEHICLES [ACORo t01, AddlUooel Rernsrke 9chedule, may be attaclied if more epece ta reQuked)
Ramos Diaz-Owner
City ot Fort CoAms is kncluded as additional msured on the Genera Liability with respect to ongoing operations of the named fnsured for the certificate holder as
required by written contract
ICATE HOI.DER
Ciry of Fort Collins
Development Review Center
281 N Coliege Ave
Fort Coilins CO 80524
ACORD 25 {2016/03)
SHOULD ANY OF THE ABOVE DESCR18E0 PQLICIES BE CANCELLED B�FOFiE
THE EXPIRATION DATE THEREOf, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH 7HE POUCY PROVISIONS.
AUTH�AIZEO RfVRESENTATiYE �
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� 1988-2015 ACORD CORPORATION. All rigfits reserved.
The ACORD name and logo are �egistered marks of ACORD
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