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HomeMy WebLinkAboutCentennial Concrete & Waterproofing - Insurance Certificate BROWBRO-05 LGUNDERSDORF ,ac'oRO CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY) `--� 12/19/2024 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(s). PRODUCER CONTACT NAME: The Mahoney Group-Mesa PHONE 730-4920 FAX 1835 South Extension Road (A/C,No,Ext):(480) (A/C,No):(480)730-4929 Mesa,AZ 85210 ADDRESS: INSURERS AFFORDING COVERAGE NAIC# INSURER A:AMCO Insurance Company 19100 INSURED INSURER B:Depositors Insurance Company 42587 Centennial Concrete&Waterproofing LLC INSURER C:NATIONWIDE MUTUAL INSURANCE COMPANY 23787 15253 E Fremont Dr INSURER D:SiriusPoint Speciality Insurance Company 16820 Centennial,CO 80112 INSURER E 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, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INS R TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF POLICY FRCP LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE X OCCUR ACP3016462474 1/1/2025 1/1/2026 DAMAGE TO RENTED 100,000 X X PREMISES Ea occurrence $ MED EXP(Any oneperson) $ 5,000 PERSONAL BADVINJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY PEC LOC PRODUCTS-COMP/OPAGG $ 2,000,000 OTHER: $ B AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1,000,000 Ea accident $ Ix ANYAUTO X X ACP3016462474 1/1/2025 1/1/2026 BODILY INJURY Per rson $ OWNED SCHEDULED AIU�T�O�SONLY AUTNOpS�y Ep BOO�DILYINJURY Per accident $ AUTOS ONLY X AUTOS ONalY PPe�P.ER n DAMAGE $ UM $ 1,000,000 A X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 5,000,000 EXCESS LIAR I I CLAIMS-MADE ACP3016462474 1/1/2025 1/1/2026 AGGREGATE $ 5,000,000 DED I I RETENTIONS $ C WORKERS COMPENSATION X PER OTH- AND EMPLOYERS'LIABI ITV STATUTE ER ANY PROPRIETOWPARTNEWEXECUTIVE Y/N --- -X ACP3016462474 1/1/2025 -'--4 4/2026 - - - --- 1;o00,000 �FFICE N/A E.L.EACH ACCIDENT b (MandWMEM EXCLWUDED?atory In�iFF�j 1,000,000 E.L.DISEASE-EA EMPLOYE $ f yes,describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ A EQ Fltr$100/BR ACP3016462474 1/1/2025 1/1/2026 Materials 300,000 D Excess Liability ARCUSXC197102025 1/1/2025 1/1/2026 4M XS 5M 4,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Complete Certificate Holder:City of Fort Collins,its officers,agents and employees CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Fort Collins THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Y ACCORDANCE WITH THE POLICY PROVISIONS. Purchasing Division PO Box 580 Fort Collins,CO 80522 AUTHORIZED REPRESENTATIVE ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD